| NPI | 1902211212 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | MICHAEL RAY KILGORE Sole/Proprietor 956-687-6196  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX H1123)  | 
| Enumeration Date | 2014-06-25 | 
| Last Update Date | 2014-06-25 |