| NPI | 1689916330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISNARDO E TREMOR Owner 936-291-2111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: TX K1707) |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX K1707) | |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2013-10-01 |