NPI age
20 years
Enumerated 2005-07-15
Across 576 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 1114926847 | RR MEDICARE PART B |
| 05 (MO) | 1114926847 | |
| 05 (GA) | 00764717D | |
| 01 (GA) | 52671236 | BCBS |
Part of a multi-provider practice. 7 other active providers share this practice address in NPPES.
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