| NPI | 1407497936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDGAR TIJERINA Billing Analyst 713-805-5027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 207X00000X Orthopaedic Surgery | |
| Enumeration Date | 2019-10-07 |
| Last Update Date | 2020-11-24 |