BRYAN BASULTO LOPEZ

HOUSTON, TX
NPI1922997295
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: WI  24-361)
Enumeration Date2025-07-01
Last Update Date2025-07-01
Business Address
BRYAN BASULTO LOPEZ CSA
18500 KATY FWY
HOUSTON, TX 77094-1110
Phone number: 305-335-0089
Mailing Address
BRYAN BASULTO LOPEZ CSA
29310 PRAIRIE ROSE CT
KATY, TX 77494-7384
Phone number: 305-335-0089