| NPI | 1992281679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY JOSEPH PORRATA Owner 817-313-6419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX SA00598) |
| Enumeration Date | 2018-07-16 |
| Last Update Date | 2018-07-16 |