NPI age
16 years
Enumerated 2009-08-12
Across 20 active internal medicine providers in Texas.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (OH) | 0069368 | |
| 01 | 07403868 | ECFMG |
Solo or small practice. No other active providers share this practice address in NPPES.
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