| NPI | 1780962456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUDRA LEANN HIEMSTRA P.C. 281-389-2720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 24722) |
| Enumeration Date | 2011-07-29 |
| Last Update Date | 2011-10-17 |