NPI age
20 years
Enumerated 2005-06-23
Across 2301 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 45D0955862 | CLIA |
| 01 | 752646025 | TAX ID |
| 01 | 3063865 | CIGNA |
| 01 (TX) | 83Z820 | BCBS |
| 05 (TX) | 085790601 |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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