| NPI | 1710454566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GE'O-VANNA SMITH Office Manager 512-595-7475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2018-10-30 |
| Last Update Date | 2019-01-19 |