| NPI | 1306004650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL WAYNE HERNANDEZ Member 713-777-4539 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2008-05-22 |