NPI age
19 years
Enumerated 2006-07-11
Across 7055 active pediatrics providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 042378203 | |
| 05 (OK) | 100156740B | |
| 05 (TX) | 200320401 |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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