| NPI | 1972350593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER EADDY Owner 830-609-8083 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2024-05-01 |
| Last Update Date | 2024-05-01 |