| NPI | 1811506538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN N HOGAN Owner 512-284-7025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine |
| Additional Taxonomies | 2083S0010X Preventive Medicine, Sports Medicine |
| Enumeration Date | 2020-07-28 |
| Last Update Date | 2020-08-01 |