| NPI | 1821536681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY ANN JOLLEY Director Of Credentialing 713-458-4169 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2017-02-01 |
| Last Update Date | 2017-02-01 |