NPI age
19 years
Enumerated 2006-11-13
Across 15966 active family medicine providers in Texas.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 75-1289579 | TAX IDENTIFICATION NUMBER |
| 01 (TX) | 0001GF | BLUE CROSS BLUE SHIELD TX |
| 05 (TX) | 082969901 |
Multi-provider organization. 1 individual provider on file at this primary address.
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