Individual
KHUSBOO SURTANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
12410 TOEPPERWEIN RD, LIVE OAK, TX 78233-3230
(210) 742-6555
Mailing address
12410 TOEPPERWEIN RD, LIVE OAK, TX 78233-3230
(210) 742-6555
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
363AM0700X
Medical Physician Assistant
Primary
PA17609
TX
Other
Enumeration date
08/22/2019
Last updated
02/12/2024
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