| NPI | 1700400850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA RACHELLE COTTLE Medical Director 512-913-2972 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2020-06-04 |
| Last Update Date | 2020-11-17 |