| NPI | 1932377603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORIS A DOEGE Managed Care Coordinator 210-804-5416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX L6110) |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: TX L6110) |
| Enumeration Date | 2008-02-15 |
| Last Update Date | 2010-01-11 |