| NPI | 1104151398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM BANASIAK Owner 281-948-4945 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 364SM0705X Clinical Nurse Specialist, Medical-Surgical |
| Enumeration Date | 2009-10-06 |
| Last Update Date | 2009-10-06 |