| NPI | 1982673455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES JASON HUBBARD Owner 512-477-8853 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: TX 1625) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2014-05-07 |