NPI age
20 years
Enumerated 2006-01-26
Across 749 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 152395301 | |
| 01 (TX) | K9626 | LICENSE NUMBER |
| 01 (TX) | 0002JE | BLUE CROSS BLUE SHIELD |
| 01 (TX) | 660003822 | RAILROAD MEDICARE |
| 01 (TX) | 45D1017258 | CLIA ID NUMBER |
| 01 (TX) | 7715345 | AETNA |
| 01 (TX) | 2011482 | UNITED HEALTHCARE |
Part of a multi-provider practice. 87 other active providers share this practice address in NPPES.
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