| NPI | 1861758609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAIME ILDEBRANDO BARILLAS Owner 832-237-5656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2012-04-05 |
| Last Update Date | 2017-05-02 |