NPI age
21 years
Enumerated 2005-05-24
Across 237 active clinic/center providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 0410DC | BCBS PROV |
| 01 | 268489 | AMERIGROUP |
| 01 | 7416610 | AETNA/MEDSOLUTIONS |
Doing-business-as, former, and alternate names recorded by NPPES.
Single-site organization. Only one practice location on file.
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