NPI age
11 years
Enumerated 2015-04-08
Across 125 active family medicine providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 402129701 | |
| 01 (TX) | 402129702 | CSHCN |
Solo or small practice. No other active providers share this practice address in NPPES.
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