| NPI | 1891049748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL B A RILEY Licensed Surgical Assistant 832-559-3870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX SA00319) |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2014-03-11 |