NPI age
19 years
Enumerated 2006-07-25
Across 105 active legal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 00500U | MEDICARE ID |
| 05 (TX) | 1233587-04 |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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