| NPI | 1922717685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELAINE WILSON Billing Director 281-962-8878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-11-21 |
| Last Update Date | 2022-12-13 |