| NPI | 1689939183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATHA SUKUMAR Owner 254-519-3131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: TX J3626) |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2012-07-10 |