| NPI | 1326497470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALFONSO JOSE BRAVO Owner 832-512-4011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX SA00284) |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2016-12-21 |