Organization
FABIOLA MEDINA CSA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FABIOLA MEDINA LSA (OWNER)
(281) 463-6309
Entity
Organization
Contact information
Practice address
16151 CAIRNWAY DR STE 210, HOUSTON, TX 77084-3555
(281) 463-6309
(281) 463-6835
Mailing address
PO BOX 3931, BROWNSVILLE, TX 78523-3931
(281) 463-6309
(281) 463-6835
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
SA00347
TX
Other
Enumeration date
12/04/2009
Last updated
12/04/2009
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