| NPI | 1821517103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENT OLSAN Owner 281-292-7411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2018-06-26 |