| NPI | 1881860948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROXANNA LAROQUE Director Of Client Experience 210-598-4262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA02366) |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2022-07-19 |