| NPI | 1588095111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA MARIE HESLOP Administrator 832-891-9989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: TX SA00475) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2013-12-08 |
| Last Update Date | 2016-04-11 |