NPI age
20 years
Enumerated 2005-08-10
Across 138 active surgery providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (IA) | 12174 | WELLMARK BCBS |
| 05 (IA) | 0101576 |
Part of a multi-provider practice. 524 other active providers share this practice address in NPPES.
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