NPI age
19 years
Enumerated 2007-01-15
Across 350 active obstetrics & gynecology providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (UT) | 184517-8905 | MEDICAL LICENSE |
| 05 (ID) | 003671100 |
Part of a multi-provider practice. 7 other active providers share this practice address in NPPES.
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