| NPI | 1154869337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALFONSO BRAVO Owner 832-512-4011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA10745) |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2018-06-20 |