| NPI | 1871805788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXIS DOUGHERTY Resident/Pgy2 832-341-9832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA (Licence: TX ENHL320) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2010-07-08 |