NPI age
20 years
Enumerated 2006-03-24
Across 1024 active otolaryngology providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 1054520-02 | |
| 01 (TX) | 1054520-01 | CSHCN |
| 01 (TX) | 87649K | BLUE SHIELD |
| 01 (TX) | 040015420 | RR/MEDICARE |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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