| NPI | 1801078241 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY FYE Deputy Director Of Finance 512-499-0090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 596183) |
| Enumeration Date | 2007-11-28 |
| Last Update Date | 2007-11-28 |