| NPI | 1942401617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD B GRIPON Doctor 409-899-4472 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0015X Psychiatry & Neurology Psychosomatic Medicine (Licence: TX D5020) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2012-07-10 |