NPI age
19 years
Enumerated 2006-12-04
Across 2632 active psychologist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 205136900 | TEXAS WORKER'S COMP |
| 01 (TX) | 23728 | STATE LICENSE |
| 01 (TX) | 00D50B | BLUE CROSS BLUE SHIELD |
| 05 (TX) | 032647201 |
Part of a multi-provider practice. 7 other active providers share this practice address in NPPES.
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