NPI age
19 years
Enumerated 2006-06-15
Across 1194 active urology providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 126479804 | |
| 01 (TX) | 0616600001 | MEDICARE PALMETTO DME # |
| 01 (TX) | 340001356 | MEDICARE RAILROAD # |
| 01 (TX) | 00FP77 | BCBS PROVIDER # |
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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