| NPI | 1801327762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIRISHA PARVATANENI Director 409-200-1950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX P0464) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2019-06-27 |