NPI age
19 years
Enumerated 2006-06-28
Across 12343 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 1120818-01 | |
| 01 | 751764435797010000 | TRICARE |
Part of a multi-provider practice. 8 other active providers share this practice address in NPPES.
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