NPI | 1932490893 |
---|---|
Entity Type | Organization |
Authorized Contact | GERARDO GUAJARDO GUAJARDO Orthodontist 281-482-2640 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: TX 23141) |
Enumeration Date | 2011-04-27 |
Last Update Date | 2011-04-27 |