| NPI | 1780204818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIJAH COLLINS CEO 281-206-7806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine |
| 261QI0500X Clinic/Center, Infusion Therapy | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 261QX0100X Clinic/Center, Occupational Medicine | |
| 291U00000X Clinical Medical Laboratory | |
| 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier | |
| Enumeration Date | 2020-04-18 |
| Last Update Date | 2020-04-18 |