| NPI | 1962896340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE BRAVO Billing Manager 915-751-1152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: TX L4382) |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2024-07-17 |