Individual
SAMUEL SEGUNDO JIMENEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SA-C
Contact information
Practice address
3903 S MASON RD, APT #111, KATY, TX 77450-7708
(786) 660-6908
Mailing address
3909 S MASON R, APT #111, KATY, TX 77450
(786) 660-6908
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
16-180
WI
Other
Enumeration date
04/18/2016
Last updated
04/18/2016
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