NPI age
20 years
Enumerated 2005-07-22
Across 130 active pediatrics providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 760465919 | TAX ID |
| 05 (TX) | 149432002 | |
| 05 (TX) | 167227101 | |
| 01 (TX) | 1083861231 | NPI |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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