| NPI | 1952634602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODRIGO CEBALLOS Medical Director 512-589-5519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: TX 678490) |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2009-09-14 |