| NPI | 1902205321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QIJUN SONG Manager 713-234-0081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX SA00504) |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2014-09-10 |