| NPI | 1871744524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENDA JOHNSON Billing Manager 512-396-8351 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: TX DC 10686) |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2008-09-30 |