| NPI | 1962245290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OSCAR DEMETRIO VILLALOBOS Owner 915-203-8186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-06-14 |
| Last Update Date | 2024-06-14 |