| NPI | 1871962191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKAEL JAMES JACOBSON Medical Doctor 210-363-5471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX L5386) |
| Enumeration Date | 2015-09-16 |
| Last Update Date | 2024-04-23 |