| NPI | 1740939818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA JOHNSON-FOWLER Owner 832-462-3781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2022-03-23 |
| Last Update Date | 2022-03-25 |