NPI age
19 years
Enumerated 2006-06-05
Across 15966 active family medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 126608203 | |
| 01 (TX) | 8F2141 | BCBS INDIVIDUAL ID NUMBER |
| 01 (TX) | 5373506 | AETNA ID NUMBER |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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