NPI age
19 years
Enumerated 2006-11-30
Across 1890 active physician assistant providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (AL) | 130341 | |
| 01 (AL) | 511-17067 | BLUE CROSS AND BLUE SHIELD |
| 01 (AL) | 102I976217 | MEDICARE PTAN |
Part of a multi-provider practice. 523 other active providers share this practice address in NPPES.
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