NPI age
19 years
Enumerated 2007-03-28
Across 237 active family medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (MS) | 17636 | STATE LICENSE |
| 01 (TX) | F7185 | ORIGINAL STATE LICENSE |
| 01 (AL) | MD24716 | STATE LICENSE |
| 01 (OK) | 22841 | STATE LICENSE |
| 01 (AZ) | 37161 | STATE LICENSE |
| 01 (LA) | MD14585R | STATE LICENSE |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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