Organization
PHOENIX SURGICAL SERVICES
Active
Organization
PHOENIX SURGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALFONSO JOSE BRAVO L.S.A (OWNER)
(832) 512-4011
Entity
Organization
Contact information
Practice address
4803 HACKAMORE BROOK CT, KATY, TX 77449-5377
(832) 512-4011
Mailing address
4803 HACKAMORE BROOK CT, KATY, TX 77449-5377
(832) 512-4011
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
SA00284
TX
Other
Enumeration date
06/09/2016
Last updated
12/21/2016
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