| NPI | 1629319587 |
|---|---|
| Doing Business As | NA |
| Entity Type | Organization |
| Authorized Contact | MUSILIU O OLATOTO Administrator 832-279-6465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 208600000X Surgery |
| 363AS0400X Physician Assistant, Surgical (Licence: TX SA00449) | |
| Enumeration Date | 2013-03-01 |
| Last Update Date | 2022-06-28 |