| NPI | 1982757209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL S. RICHARD Executive Director 979-532-1749 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2011-06-14 |