NPI age
19 years
Enumerated 2007-02-08
Across 4038 active specialist providers in Texas.
2 secondary locations on file with NPPES.
20 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 117103 | CHIPS |
| 05 (TX) | 110661901 | |
| 01 (TX) | 00530D | BLUE CROSS BLUE SHIELD TX |
| 01 (TX) | 110661902 | MEDICAID CSHCN NUMBER |
Multi-provider organization. 20 individual providers on file at this primary address. Plus 2 secondary practice locations.
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