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Individual

MR. BYSMARK A ACEBO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LSA

Contact information

Practice address
20023 SKY HOLLOW LN, KATY, TX 77450-5219
(832) 713-9153
Mailing address
20023 SKY HOLLOW LN, KATY, TX 77450-5219
(832) 713-9153

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
SA00008
TX
363AS0400X
Surgical Physician Assistant
Primary
SA 0008
TX

Other

Enumeration date
01/15/2007
Last updated
01/28/2019
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