NPI age
18 years
Enumerated 2008-01-10
Across 125 active family medicine providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | Q8681 | MEDICAL LICENSE |
| 01 (AZ) | R877 | TRAINING PERMIT |
Part of a multi-provider practice. 100 other active providers share this practice address in NPPES.
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