| NPI | 1861753972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW HIGGS Owner 682-478-6405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: TX N6352) |
| Enumeration Date | 2012-06-05 |
| Last Update Date | 2012-06-05 |