| NPI | 1861751687 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE M REED CEO/Owner 936-671-3106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX RN614635) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2014-10-17 |