Registry details
Type
Individual
Primary specialty
Orthopaedic Surgery
Enumerated
Jan 9, 2007
License(s)
M 5017 (TX), M5017 (TX)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 11511 SHADOW CREEK PKWY CREDENTIALING SERVICES | Pearland, TX 77584-7298 | 713-442-0000 |
| LOCATION | 2727 W HOLCOMBE BLVD 2ND FLOOR - ORTHOPEDICS | Houston, TX 77025-1669 | 713-442-0000 |
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