NPI age
19 years
Enumerated 2006-06-12
Across 12343 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | K9315 | STATE LICENSE |
| 01 (TX) | 0055MB | BCBS |
| 05 (TX) | 038789602 | |
| 01 (TX) | 116563101 | FIRST CARE |
Part of a multi-provider practice. 34 other active providers share this practice address in NPPES.
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