NPI age
19 years
Enumerated 2006-07-17
Across 15966 active family medicine providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 45-2578435-002 | TRICARE |
| 01 (TX) | 752616977118 | TRICARE |
| 05 (TX) | 111773104 | |
| 01 (TX) | 0089BS | BCBS |
| 01 (TX) | 45-2578435-001 | TRICARE |
| 01 (TX) | 8ED759 | BCBS |
Part of a multi-provider practice. 17 other active providers share this practice address in NPPES.
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