NPI age
20 years
Enumerated 2006-05-16
Across 7055 active pediatrics providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 8W4320 | BCBS PROVIDER ID |
| 01 (TX) | 7604028 | AETNA PROVIDER NUMBER |
| 01 (TX) | 10060071 | AMERIGROUP PROVIDER ID |
| 05 (TX) | 170312602 |
Part of a multi-provider practice. 13 other active providers share this practice address in NPPES.
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