NPI age
19 years
Enumerated 2006-08-01
Across 576 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 1225260 (07) | |
| 01 (TX) | 8P5870 | BCBS INDIVIDUAL NUMBER |
| 01 (TX) | P00175170 | RR MEDICARE INDIVIDUAL # |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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