| NPI | 1871252809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK GALLARDO Owner/ Authorized Official 915-235-5564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2021-12-17 |
| Last Update Date | 2024-11-21 |