| NPI | 1942517172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL TREVINO President / CEO 409-899-7102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363LG0600X Nurse Practitioner Gerontology | |
| Enumeration Date | 2010-09-09 |
| Last Update Date | 2022-10-19 |