NPI age
20 years
Enumerated 2005-11-19
Across 2087 active general practice providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TN) | 00LR55 | BCBS |
| 05 (TX) | 034757701 |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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