| NPI | 1992198923 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FLORENCE COAXUM Owner 713-732-6191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: TX 23109) |
| Enumeration Date | 2015-03-16 |
| Last Update Date | 2015-03-16 |