NPI age
20 years
Enumerated 2005-11-10
Across 1738 active physical medicine & rehabilitation providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 188093202 | |
| 01 (TX) | M1395 | STATE MEDICAL LICENSE |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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