NPI age
16 years
Enumerated 2010-04-01
Across 7055 active pediatrics providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 691720 | AMERICAN BOARD OF PEDIATRICS CERTIFICATION |
| 01 (TX) | P7646 | TX MEDICAL BOARD PHYSICIAN FULL PERMIT |
Solo or small practice. No other active providers share this practice address in NPPES.
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