NPI age
20 years
Enumerated 2005-11-02
Across 4633 active obstetrics & gynecology providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 810590634 | TAX ID |
| 01 (TX) | 0039JY | BC/BS PROVIDER NUMBER |
| 01 (TX) | 91252075 | NEW MEXICO MEDICAID # |
| 05 (TX) | 040148103 |
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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