| NPI | 1841438504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YVONNE D LONGORIA Owner 210-804-0022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| 208VP0014X Pain Medicine Interventional Pain Medicine | |
| 261Q00000X Clinic/Center | |
| 291U00000X Clinical Medical Laboratory | |
| 305S00000X Point of Service | |
| 363LA2200X Nurse Practitioner Adult Health | |
| 363LG0600X Nurse Practitioner Gerontology | |
| Enumeration Date | 2009-02-03 |
| Last Update Date | 2014-01-28 |