| NPI | 1700425188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STELLA IMMANUEL Director Owner 281-506-7412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine |
| Enumeration Date | 2020-01-02 |
| Last Update Date | 2020-01-02 |