| NPI | 1881101483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDY RENEE SMITH Credentialing COO Rdinator 281-824-1480 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 208000000X Pediatrics |
| 261QC1500X Clinic/Center Community Health | |
| Enumeration Date | 2018-01-04 |
| Last Update Date | 2024-03-26 |