| NPI | 1730668567 |
|---|---|
| Doing Business As | AVIVA DERMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | SIMONE SUZETTE STALLING Manager 713-468-0303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Enumeration Date | 2018-08-13 |
| Last Update Date | 2023-01-04 |