| NPI | 1891329835 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FUNMILOLA ODUTAYO Provider/ Nurse Practitioner 832-207-8224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2020-02-28 |
| Last Update Date | 2023-07-31 |