| NPI | 1952727109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL LEE SEGURA Administrator 512-940-1027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX P3769) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: TX P3769) |
| Enumeration Date | 2014-03-12 |
| Last Update Date | 2014-12-09 |