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FORT BLISS, TX
NPI1134881253
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
Enumeration Date2021-10-06
Last Update Date2021-10-06
Business Address
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18511 HIGHLANDER MEDICS STREET WBAMC
FORT BLISS, TX 79918
Phone number: 202-830-8098
Mailing Address
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18511 HIGHLANDER MEDICS STREET WBAMC
FORT BLISS, TX 79918
Phone number: 915-569-3213
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