| NPI | 1700157666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIDA JABERANSARI President 713-850-1190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA04515) |
| Enumeration Date | 2012-01-24 |
| Last Update Date | 2012-01-24 |