NPI age
7 years
Enumerated 2019-03-07
Across 1165 active clinic/center providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 803226921 | CERTIFICATE OF FILING |
| 01 (TX) | N5987 | TEXAS MEDICAL BOARD LICENSE |
Single-site organization. Only one practice location on file.
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