| NPI | 1821159518 |
|---|---|
| Former Legal Business Name | TEXAS BAND OF KICKAPOO |
| Entity Type | Organization |
| Authorized Contact | JUANITA ELIZONDO Office Manager 830-421-5903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2023-03-14 |