NPI age
15 years
Enumerated 2011-03-21
Across 1194 active urology providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (IL) | 036140193 | STATE LICENSE |
| 01 (TX) | U1870 | TEXAS MEDICAL BOARD |
Part of a multi-provider practice. 18 other active providers share this practice address in NPPES.
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