| NPI | 1962098822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TROUPER KRUEGER Cso Hhr 979-324-5456 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 207QA0401X Family Medicine, Addiction Medicine | |
| Enumeration Date | 2020-12-15 |
| Last Update Date | 2020-12-15 |