| NPI | 1770841991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL KRIDEL Owner 713-798-7217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: TX BP-10025787) |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2012-04-25 |