| NPI | 1992473391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY A WILSON President 409-923-0012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Additional Taxonomies | 101Y00000X Counselor |
| 163WL0100X Registered Nurse, Lactation Consultant | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2021-08-31 |
| Last Update Date | 2021-08-31 |