| NPI | 1902661887 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | MARCUS DE LA FUENTE Family Nurse Practitioner Owner 210-264-6681  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family | 
| Enumeration Date | 2024-02-19 | 
| Last Update Date | 2024-02-19 |