NPI age
19 years
Enumerated 2006-08-18
Across 4038 active specialist providers in Texas.
4 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 00R73W | MD GRP PROV # |
| 01 (TX) | 00C21N | CRNA GRP PROV # |
Multi-provider organization. 4 individual providers on file at this primary address.
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