| NPI | 1063468445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID R MACK Managing Partner 281-664-2107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA05232) |
| 363A00000X Physician Assistant | |
| 363A00000X Physician Assistant (Licence: TX PA02925) | |
| 363A00000X Physician Assistant (Licence: TX PA01427) | |
| 208100000X Physical Medicine & Rehabilitation | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2016-11-30 |