| NPI | 1336771062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB D SKORUPPA President 361-537-3209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2020-02-11 |
| Last Update Date | 2020-02-11 |