NPI age
11 years
Enumerated 2015-02-16
Across 159 active surgery providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (NE) | 31987 | NEBRASKA STATE PHYSICIAN LICENSE |
| 01 (TX) | BP10091081 | TEXAS PHYSICIAN IN TRAINING LICENSE |
Part of a multi-provider practice. 1394 other active providers share this practice address in NPPES.
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