| NPI | 1619292059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FERNANDO BUESO Owner 281-463-6309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX SA00300) |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2010-03-29 |