| NPI | 1073968210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELEAZAR FLORES Owner 281-210-9934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 208600000X Surgery (Licence: TX SA00652) |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2020-12-02 |