NPI age
19 years
Enumerated 2007-02-22
Across 278 active preferred provider organization providers in Texas.
3 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 185365701 | |
| 05 (TX) | 000017300 | |
| 05 (TX) | 001012821 |
Multi-provider organization. 3 individual providers on file at this primary address.
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