| NPI | 1447507157 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINA MICHELLE GALLARDO Accounts Billing Manager 832-637-7127 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2012-08-13 |
| Last Update Date | 2017-03-08 |