| NPI | 1891842258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH IMOGENE SMILEY Owner 512-751-0812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2022-07-21 |