NPI | 1780491340 |
---|---|
Entity Type | Organization |
Authorized Contact | BENJAMIN WALKER Practice Manager 512-351-6053 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
Additional Taxonomies | 207Q00000X Family Medicine |
261QP2300X Clinic/Center, Primary Care | |
363L00000X Nurse Practitioner | |
Enumeration Date | 2024-12-16 |
Last Update Date | 2025-01-28 |