| NPI | 1245703248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITCHELL HERNANDEZ-LUCIO Managing Member 713-578-0697 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2019-01-02 |
| Last Update Date | 2020-04-02 |