| NPI | 1932607074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES LENFORD HOUSE Certified Surgical Assistant 832-967-4960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2018-01-23 |
| Last Update Date | 2018-01-23 |