| 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 |