| NPI | 1760619944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID W. POWELL Owner 713-208-9344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX J9788) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA05189) |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2011-09-15 |