| NPI | 1932593530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES ALBERT GRISMORE Owner 210-598-8035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2024-06-18 |