NPI age
20 years
Enumerated 2005-08-19
Across 15966 active family medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 123790106 | |
| 01 (TX) | 115488101 | FIRSTCARE |
| 01 (TX) | 121515 | SUPERIOR |
| 01 (TX) | 84130Y / 0044EB | BLUE CROSS BLUE SHIELD |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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