| NPI | 1831630565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID R SPROUSE Provider/ Owner 830-896-4711 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX H2802) |
| Enumeration Date | 2017-03-14 |
| Last Update Date | 2017-03-21 |