NPI age
13 years
Enumerated 2012-06-07
Across 15966 active family medicine providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (OK) | 200905210A | |
| 05 (TX) | 399170501 | |
| 05 (AR) | 204130001 | |
| 01 (TX) | 1G2546 | MEDICARE |
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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