| NPI | 1316361553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB D SKORUPPA CEO 361-876-6689 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX 00374) |
| Enumeration Date | 2014-02-07 |
| Last Update Date | 2014-02-07 |