| NPI | 1881578961 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JASON MARTIN Owner 512-234-4685 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine | 
| Additional Taxonomies | 363L00000X Nurse Practitioner | 
| Enumeration Date | 2025-08-02 | 
| Last Update Date | 2025-08-04 |