| NPI | 1184303836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTONIO JASON MORQUECHO CEO,Lsa 254-421-4876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2023-07-11 |
| Last Update Date | 2023-08-15 |