NPI age
19 years
Enumerated 2007-04-12
Across 4038 active specialist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 85W020 | BLUE CROSS BLUE SHIELD |
| 01 (TX) | J2828 | TEXAS LICENSE NUMBER |
| 01 (TX) | 030005344 | RAILROAD MEDICARE |
| 01 (TX) | 00254T | MEDICARE GROUP ID |
| 01 (TX) | 00N24T | BCBS GROUP ID |
Part of a multi-provider practice. 21 other active providers share this practice address in NPPES.
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