| NPI | 1093957466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDGAR FRAGOSO Owner 281-463-6309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX SA00305) |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2009-04-01 |