NPI age
19 years
Enumerated 2006-07-18
Across 4391 active psychiatry & neurology providers in Texas.
4 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 1151755-02 | |
| 05 (NM) | F28006 | |
| 01 (TX) | TXB147437 | MEDICARE |
| 05 (TX) | 1013935675 |
Part of a multi-provider practice. 68 other active providers share this practice address in NPPES.
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