NPI age
19 years
Enumerated 2007-01-29
Across 6039 active emergency medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 138506424 | |
| 01 (TX) | 752616977118 | TRICARE |
| 01 (TX) | 8DC102 | BCBS |
| 01 (TX) | 75-0818167-022 | TRICARE |
Part of a multi-provider practice. 17 other active providers share this practice address in NPPES.
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