| NPI | 1952844813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICAL SAMUELSON DUVALL CEO 210-602-5578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q0169) |
| Additional Taxonomies | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: TX N8628) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: TX Q0169) | |
| Enumeration Date | 2016-11-28 |
| Last Update Date | 2016-11-28 |