| NPI | 1114366721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY ROSILEZ Managing Memeber 832-887-9037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX SA00350) |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2013-06-17 |