NPI age
19 years
Enumerated 2007-04-20
Across 12343 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (MI) | 5101016949 | MI LICENSE # |
| 01 (MI) | 5315027229 | MI CONTROL SUBSTANCE # |
| 01 (CA) | 20A13622 | MEDICAL LICENSE |
| 01 (TX) | R1719 | MEDICAL LICENSE |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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