| NPI | 1831268135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERONICA M. SAYAVEDRA Program Director 956-585-2439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: TX 18814) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2020-08-22 |