NPI age
20 years
Enumerated 2006-05-11
Across 1136 active podiatrist providers in Texas.
3 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 2363 | MEDICAL LICENSE |
| 01 (IN) | 07001021A | IN LICENSE |
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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