NPI age
19 years
Enumerated 2006-09-02
Across 4038 active specialist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 161655901 | MEDICAID GROUP PROVIDER # |
| 01 (TX) | 00471V | GROUP MEDICARE PTAN # |
Doing-business-as, former, and alternate names recorded by NPPES.
Single-site organization. Only one practice location on file.
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