| NPI | 1740336171 |
|---|---|
| Former Legal Business Name | BROOKSIDE WOMENS MEDICAL SERVICES |
| Entity Type | Organization |
| Authorized Contact | LENDOL L. DAVIS O Wner 512-443-9595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2023-10-26 |