| NPI | 1710011259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRASEMA CAMPA Administrative Assistant 713-697-2631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 22558) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 16842) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2012-02-01 |