NPI age
20 years
Enumerated 2005-12-29
Across 1691 active family medicine providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 177765802 | |
| 01 (TX) | 150659102 | FIRSTCARE |
| 01 (TX) | 0045NS | BLUE CROSS BLUE SHIELD |
Part of a multi-provider practice. 28 other active providers share this practice address in NPPES.
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