NPI | 1770107856 |
---|---|
Entity Type | Organization |
Authorized Contact | TRACY L BASSO Owner 832-777-7570 |
Organization Subpart ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery |
Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
Enumeration Date | 2020-06-03 |
Last Update Date | 2024-04-16 |