NPI | 1689729295 |
---|---|
Entity Type | Organization |
Authorized Contact | BRIAN R. LOGGINS Practice Administrator 210-477-2626 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: TX E6144) |
Enumeration Date | 2007-01-24 |
Last Update Date | 2022-08-04 |