NPI age
20 years
Enumerated 2005-06-17
Across 15966 active family medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 104196404 | |
| 01 (TX) | 3218486 | AETNA HMO |
| 01 (TX) | 41983B | AETNA |
| 01 (TX) | 8J5600 | BLUE CROSS/BLUE SHIELD |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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