| NPI | 1992061188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN L RIVERS Health Services Administrator 979-823-1879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2400X Clinic/Center Prison Health |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2012-04-02 |