| NPI | 1104263318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK S LISCH Owner 832-368-6841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX 0787) |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2014-04-29 |