| NPI | 1902170814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERICK F LYKES Owner 361-575-8203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: TX D3550) |
| Enumeration Date | 2012-02-24 |
| Last Update Date | 2012-02-24 |