NPI age
15 years
Enumerated 2011-05-26
Across 803 active pain medicine providers in Texas.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | BP1 - 0040943 | PIT PERMIT NUMBER |
| 01 (TX) | S0499 | TEXAS MEDICAL LICENSE |
| 01 (TX) | 1K5259 | TEXAS MEDICARE |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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