| NPI | 1902183577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIMMY KYLE MYERS Owner And Operator 512-331-2700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 63765) |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2011-11-10 |
| Last Update Date | 2021-01-05 |