| NPI | 1902943996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUANE A DIETZ President And Medical Director 210-732-7030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX H9885) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2020-08-22 |