NPI age
17 years
Enumerated 2008-11-03
Across 15966 active family medicine providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (VA) | 0101243774 | VIRGINIA STATE LICENSE |
Part of a multi-provider practice. 22 other active providers share this practice address in NPPES.
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