| NPI | 1467502849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BYSMARK ABRAHAM ACEBO President 281-829-0941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: TX SA0008) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2020-08-22 |