| NPI | 1730412271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON & CANDICE DEMATTIA Owners 281-255-3838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M2306) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX M2305) |
| Enumeration Date | 2009-09-16 |
| Last Update Date | 2011-09-21 |