| NPI | 1942854831 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIR M ALI Owner/Provider 832-912-3791 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine |
| Enumeration Date | 2019-07-29 |
| Last Update Date | 2025-07-15 |