| NPI | 1851614580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYALICE COLLINS Office Manager 936-756-5866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: TX F7846) |
| Enumeration Date | 2010-03-09 |
| Last Update Date | 2010-03-09 |