NPI age
14 years
Enumerated 2012-05-07
Across 3379 active specialist/technologist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 169033101 | |
| 01 (TX) | 454849 | MEDICARE |
Part of a multi-provider practice. 19 other active providers share this practice address in NPPES.
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