| NPI | 1164223749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GABRIEL LEWIS PETTY Owner 512-745-3037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| Enumeration Date | 2025-03-20 |
| Last Update Date | 2025-03-28 |