| NPI | 1699172890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIE RODRIGUEZ Office Manager 281-463-7208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: TX 0644) |
| Enumeration Date | 2014-12-03 |
| Last Update Date | 2014-12-03 |