| NPI | 1972819027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIAS YARRITO CEO 936-760-6591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other Surgical Assistant (Licence: TX SA00395) |
| 246ZC0007X Specialist/Technologist, Other Surgical Assistant (Licence: TX 3341) | |
| 246ZS0410X Specialist/Technologist, Other Surgical Technologist (Licence: TX 548445) | |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2015-11-24 |