NPI | 1750657920 |
---|---|
Entity Type | Organization |
Authorized Contact | JEFFREY L BUTTS Medical Director 512-426-8343 |
Organization Subpart ? | No |
Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: TX H7939) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 672526) |
Enumeration Date | 2012-03-31 |
Last Update Date | 2014-10-07 |