| NPI | 1881826378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN R RUSSELL President/Physician 281-440-4089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX L0557) |
| Enumeration Date | 2009-08-17 |
| Last Update Date | 2011-11-16 |