| NPI | 1841509395 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STANTON PACKARD President 281-606-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: TX J6641) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX J6641) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX J6641) | |
| Enumeration Date | 2010-10-01 |
| Last Update Date | 2010-10-01 |