| NPI | 1730746595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL RILEY Owner 713-992-1086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2023-02-06 |