NPI age
19 years
Enumerated 2006-07-20
Across 12343 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 9797B | ECFMG |
| 05 (TX) | 138522113 | |
| 01 (TX) | H6743 | LICENSE |
| 01 (TX) | 20072680 | DPS |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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