| NPI | 1841471463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR DANIEL TREVINO President 956-727-2997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX G7898) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: TX G7898) | |
| Enumeration Date | 2007-11-26 |
| Last Update Date | 2024-01-24 |