| NPI | 1689863169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH D WILGERS Family Practitioner 409-832-8600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 146M00000X Emergency Medical Technician, Intermediate (Licence: TX H11697) |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2022-10-06 |