NPI age
16 years
Enumerated 2009-08-13
Across 4038 active specialist providers in Texas.
20 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 285096801 | |
| 01 (TX) | 1023240751 | GROUP NPI |
| 01 (TX) | 1659364412 | INDIVIDUAL NPI |
| 01 (TX) | 0039SQ | BLUE CROSS GROUP PROVIDER NUMBER |
Doing-business-as, former, and alternate names recorded by NPPES.
Multi-provider organization. 20 individual providers on file at this primary address.
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