NPI age
20 years
Enumerated 2005-08-10
Across 7055 active pediatrics providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 123913904 | |
| 01 (PA) | MD-052944-L | PA MEDICAL LICENCE |
| 01 (FL) | ME 74872 | FL MEDICAL LICENCE |
| 05 (TX) | 123913905 | |
| 01 (PR) | 011583 | PR MEDICAL LICENCE |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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