NPI | 1700096070 |
---|---|
Entity Type | Organization |
Authorized Contact | GRACIELA MORENO Physician Owner/President 210-373-0880 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: TX L4580) |
Enumeration Date | 2007-05-23 |
Last Update Date | 2023-12-26 |