NPI age
20 years
Enumerated 2006-03-28
Across 576 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 104104805 | |
| 01 (TX) | 830007016 | RR/MEDICARE |
| 01 (TX) | 1041048-01 | CSHCN |
| 05 (TX) | 1041048-02 | |
| 01 (TX) | 84193K | BLUE SHIELD |
| 05 (GA) | 003138482B | |
| 05 (LA) | 2128469 | |
| 05 (MS) | 08031892 | |
| 01 (GA) | Q45009 | SC MEDICAID |
| 05 (TX) | 104104804 |
Part of a multi-provider practice. 3675 other active providers share this practice address in NPPES.
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