| NPI | 1851333074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STELLA MONTEMAYOR Credentialing Specilist 936-521-6109 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2020-07-16 |