| NPI | 1992093082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYLVIA AMY PENNIE Authorized Official 832-656-0597 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX SA00379) |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2017-09-08 |