NPI age
19 years
Enumerated 2006-07-25
Across 4391 active psychiatry & neurology providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 136879710 | |
| 01 (TX) | 5295014 | AETNA NUMBER |
| 01 (TX) | 061730 | VALUE OPTIONS NUMBER |
| 01 (TX) | 00T73H | BLUE CROSS BLUE SHIELD |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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