NPI age
19 years
Enumerated 2006-09-14
Across 1194 active urology providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 104042005 | |
| 05 (TX) | 104042004 | |
| 01 (TX) | P01843066 | RAILROAD |
| 01 (TX) | 751531693 | TAX ID # |
| 01 | 8B6833 | MEDICARE PTAN |
Part of a multi-provider practice. 37 other active providers share this practice address in NPPES.
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