| NPI | 1730629403 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON BOYER Owner 281-837-3757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: TX 2-5626) |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2017-03-01 |