| NPI | 1770002107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROLAND F MENA Physician Assistant 210-994-6181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA00125) |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2022-07-21 |