| NPI | 1962691881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT DUANE GUERRA Administrator 956-716-8909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: TX 001524) |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2007-10-16 |