NPI age
19 years
Enumerated 2007-03-16
Across 1466 active clinic/center providers in Texas.
3 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 164983201 | |
| 01 (TX) | K9522 | TEXAS MEDICAL LICENSE # |
| 01 (TX) | 00462W | MEDICARE |
| 05 (TX) | 127521620 | |
| 01 (MS) | 14985 | MEDICAL LICENSE # |
| 01 | 1780670315 | NPI |
Multi-provider organization. 3 individual providers on file at this primary address.
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