| NPI | 1760102644 |
|---|---|
| Former Legal Business Name | ATHENA MEDICAL CLINIC LLC |
| Entity Type | Organization |
| Authorized Contact | IOLANI MAE SY AVES Managing Member 713-584-9013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Enumeration Date | 2022-08-31 |
| Last Update Date | 2023-06-23 |