| NPI | 1457384158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAIME L MAYORAL Owner 210-212-4114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: TX j9199) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX j9199) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2009-04-03 |