| NPI | 1891126959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDI K NUTT Physician Practice Director 830-278-3086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2013-11-27 |
| Last Update Date | 2017-02-28 |