NPI age
20 years
Enumerated 2006-01-04
Across 2 active clinic/center providers in Texas.
20 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | HH6032 | BLUE CROSS BLUE SHIELD |
| 01 (TX) | 4596776 | NCPDP |
| 05 (TX) | 021757201 |
Doing-business-as, former, and alternate names recorded by NPPES.
Multi-provider organization. 20 individual providers on file at this primary address.
Subpart of 59th Mdw-Whasc-Lackland.
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