| NPI | 1689902389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY MURRAH Provider 210-725-6293 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: TX 127885) |
| Enumeration Date | 2009-11-18 |
| Last Update Date | 2009-11-18 |