| NPI | 1699154716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD STOVALL Member 512-835-8100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA09247) |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2015-05-21 |