| NPI | 1780873463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AZREENA BALSAVER THOMAS President/Owner 210-593-0900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX H6648) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2007-10-18 |
| Last Update Date | 2023-08-24 |