| NPI | 1841458965 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COREEN VON FAZAKERLY Nurse Practitioner 713-798-4696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: TX 511846) |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2008-05-27 |