NPI age
20 years
Enumerated 2005-09-19
Across 15966 active family medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 111765701 | |
| 01 (TX) | P00084054 | MEDICARE RAILROAD |
| 01 (TX) | 00GW70 | BCBS |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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