| NPI | 1922963073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNINE DENISE THOMAS Owner 210-831-4612 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2025-12-22 |
| Last Update Date | 2025-12-22 |