| NPI | 1730590761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMEON TRYON Operations Officer 832-946-7919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X (Licence: TX 801859664) |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services (Licence: TX 801859664) |
| 261QP2300X Clinic/Center, Primary Care (Licence: TX 801859664) | |
| 261QP3300X Clinic/Center, Pain (Licence: TX 801859664) | |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2014-05-13 |