| NPI | 1205299138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE PAVLAS Pa C 210-887-3272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA09170) |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2016-03-29 |