| NPI | 1861630329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILIANA C. MANZANO Licensed Surgical Assistant 281-829-5417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX SA00301) |
| Enumeration Date | 2009-01-21 |
| Last Update Date | 2009-01-21 |