NPI age
20 years
Enumerated 2005-11-23
Across 18 active clinic/center providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | P00100956 | RRMCR |
| 05 (TX) | 1646895-01 | |
| 01 (TX) | 7252420 | AETNA |
| 01 (TX) | HH1592 | BCBS |
Single-site organization. Only one practice location on file.
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