| NPI | 1871002451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER J BENNETT Owner 281-547-0706 |
| Organization Subpart ? | No |
| Primary Taxonomy | 293D00000X Physiological Laboratory |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2017-09-26 |
| Last Update Date | 2018-01-22 |