NPI age
19 years
Enumerated 2006-08-30
Across 1738 active physical medicine & rehabilitation providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 0479743 02 | |
| 01 (TX) | J6036 | TX LICENSURE MEDICAL BOARD |
| 01 | 142726600 | US DEPARTMENT OF LABOR |
Part of a multi-provider practice. 7 other active providers share this practice address in NPPES.
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