NPI age
19 years
Enumerated 2006-08-11
Across 7055 active pediatrics providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 40032558 | TX- DPS |
| 01 (TX) | E9960 | STATE LICENSE |
Part of a multi-provider practice. 25 other active providers share this practice address in NPPES.
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