NPI age
20 years
Enumerated 2006-04-14
Across 15966 active family medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 121333203 | |
| 01 (TX) | 760559868 | COMMERCIAL |
| 01 (TX) | 0085BN | BLUE CROSS |
| 01 (TX) | 10021474 | AMERIGROUP |
| 05 (TX) | 121333204 |
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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