NPI age
20 years
Enumerated 2006-05-11
Across 2301 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 1360869-02 | |
| 01 (TX) | 4376993 | AETNA PROVIDER ID |
| 05 (TX) | 136086909 | |
| 05 (TX) | 1360869-05 | |
| 05 (TX) | 1360869-11 | |
| 01 (TX) | 86462K | BCBS |
Part of a multi-provider practice. 10 other active providers share this practice address in NPPES.
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