| NPI | 1982069068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WADE A GRAHAM Owner 956-429-4900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: TX 130305) |
| Enumeration Date | 2015-12-16 |
| Last Update Date | 2017-03-10 |