NPI age
19 years
Enumerated 2006-08-24
Across 126 active surgery providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | P02601720 | MCRR |
| 05 (TX) | 163414909 |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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