| NPI | 1760456644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KESHA ELLISON Administration 281-344-1715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: TX 008306) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2020-08-22 |