| NPI | 1851690499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT A MORENO Prsident 915-577-0051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 152W00000X Optometrist |
| 207R00000X Internal Medicine | |
| 207RG0100X Internal Medicine, Gastroenterology | |
| 207RR0500X Internal Medicine, Rheumatology | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2011-03-22 |
| Last Update Date | 2011-03-22 |