| NPI | 1841651304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS DAVENPORT Administrator 210-237-4400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX 1351) |
| Enumeration Date | 2016-03-11 |
| Last Update Date | 2016-03-11 |