NPI age
12 years
Enumerated 2013-07-10
Across 15966 active family medicine providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | P02601737 | MCRR |
| 05 (TX) | 363041001 | |
| 05 (TX) | 636041003 |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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