NPI age
20 years
Enumerated 2006-02-02
Across 4038 active specialist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (MO) | 205038003 | |
| 05 (KS) | 100369440A |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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