NPI age
19 years
Enumerated 2006-08-16
Across 4038 active specialist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (NM) | U8947 | MEDICAID |
| 05 (TX) | 080701802 | |
| 01 (TX) | 100012089 | RAILROAD MEDICARE |
| 01 (TX) | 126089100 | FIRSTCARE |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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