NPI age
19 years
Enumerated 2006-08-16
Across 4038 active specialist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (CA) | A95151 | MEDICAL LICENSE |
| 01 (TX) | N3325 | STATE MEDICAL LICENSE |
Part of a multi-provider practice. 13 other active providers share this practice address in NPPES.
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