| NPI | 1114212297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS MONTOYA Managing Director 210-240-4854 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA06048) |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2020-03-17 |