NPI age
18 years
Enumerated 2007-09-20
Across 2087 active general practice providers in Texas.
3 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (CO) | 6593 | MEDICAL LICENSE |
| 01 (TX) | S8077 | TEXAS MEDICAL LICENSE |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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