NPI age
19 years
Enumerated 2006-06-03
Across 159 active surgery providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (IN) | 000000622067 | ANTHEM |
| 05 (IN) | 200876730 | |
| 05 (OH) | 0122745 | |
| 05 (MI) | 4652699 |
Part of a multi-provider practice. 9 other active providers share this practice address in NPPES.
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