NPI age
19 years
Enumerated 2006-10-13
Across 7055 active pediatrics providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 136442406 | |
| 01 (TX) | 136442401 | CSHCN |
| 01 (TX) | 89G070 | BLUE CROSS BLUE SHIELD |
Part of a multi-provider practice. 56 other active providers share this practice address in NPPES.
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