NPI age
20 years
Enumerated 2005-06-14
Across 15966 active family medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 111744204 | |
| 01 (TX) | 080080135 | MEDICARE, RR |
| 05 (TX) | 111744202 | |
| 05 (TX) | 111744203 | |
| 01 (TX) | 111744203 | EPSDT |
Part of a multi-provider practice. 7 other active providers share this practice address in NPPES.
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