NPI age
20 years
Enumerated 2006-03-30
Across 3028 active surgery providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 1181562-04 | |
| 01 (TX) | 84801K | BLUE SHIELD |
| 01 (TX) | 020047186 | RR/MEDICARE |
| 05 (TX) | 1181562-01 |
Part of a multi-provider practice. 57 other active providers share this practice address in NPPES.
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