NPI age
19 years
Enumerated 2006-12-06
Across 15966 active family medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 118617303 | |
| 01 (TX) | J-4160 | TEXAS PHYSICAN PERMIT |
| 01 (TX) | N0087586 | DPS REGISTRATION NUMBER |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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