NPI age
20 years
Enumerated 2005-11-22
Across 159 active surgery providers in Texas.
5 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (MA) | 2021536 | |
| 01 (NC) | 1431R | BCBS |
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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