| NPI | 1740485804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEGGY WUNDERLICH-PIPKIN Owner 832-859-2417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: TX 09720) |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2020-08-22 |