NPI age
14 years
Enumerated 2011-05-30
Across 1632 active dermatology providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 558763 | PHYSICIAN IN TRAINING PERMIT |
| 01 (TX) | 8FA656 | BCBS PV # |
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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