NPI age
20 years
Enumerated 2006-04-11
Across 3028 active surgery providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 159869004 | |
| 01 (TX) | P0062953 | RAILROAD GBA - RAILROAD MEDICARE |
| 01 (TX) | P01090493 | RAILROAD MEDICARE PTAN |
| 01 (TX) | 8DE529 | BC/BS # |
| 01 (TX) | MDK7163TX | WORKERS COMPENSATION |
| 05 (TX) | 159869001 | |
| 01 (TX) | 8J1711 | BC/BX TX# |
Part of a multi-provider practice. 17 other active providers share this practice address in NPPES.
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