NPI age
19 years
Enumerated 2006-08-07
Across 387 active specialist/technologist, other providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 00455Q | MEDICARE PROVIDER ID |
| 01 (TX) | 071693 | NATNL CERT SURGICAL TECH |
| 01 (TX) | SA00093 | TEXAS STATE BOARD OF MEDI |
| 01 (TX) | 83628 | NAT CERT SURGICAL TECH |
| 01 | 8F0641 | BLUE CROSS PROVIDER # |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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