NPI age
19 years
Enumerated 2007-02-12
Across 1882 active technician providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 006581 | LICENSE NUMBER |
| 01 (TX) | 000019600 | DADS CONTRACT NUMBER |
| 01 (TX) | 345520162 | SUBMITTER ID |
Single-site organization. Only one practice location on file.
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