| NPI | 1710268305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARILOU ORO Executive Director 800-409-1920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX H5039) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX H5039) |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2011-09-09 |
| Last Update Date | 2022-01-05 |