NPI age
18 years
Enumerated 2007-06-26
Across 223 active surgery providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (IL) | 036-118605 | IL STATE LIC |
| 01 (TX) | N4276 | TX STATE MEDICAL LIC |
Part of a multi-provider practice. 4085 other active providers share this practice address in NPPES.
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