| NPI | 1295158475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN CARLOS BUSTOS President 713-984-9918 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX SA00382) |
| Enumeration Date | 2014-01-24 |
| Last Update Date | 2014-02-04 |