| NPI | 1639653348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID CLARENCE MCCOWAN Licensed Surgical Pa/Assistant 832-353-0636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2018-09-18 |
| Last Update Date | 2019-10-29 |