NPI age
20 years
Enumerated 2005-09-30
Across 4038 active specialist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (LA) | L#014100 | LOUISIANA MEDICAL LICENSE |
| 01 (TX) | 40048923 | TEXAS CONTROLLED SUB. LIC |
| 01 (TX) | G2379 | TX STATE MEDICAL LICENSE |
| 05 (TX) | 114062601 | |
| 01 (AR) | R-3021 | ARKANSAS MEDICAL LICENSE |
| 05 (AR) | 103414001 | |
| 01 (OK) | 19284 | OKLAHOMA MEDICAL LICENSE |
Part of a multi-provider practice. 132 other active providers share this practice address in NPPES.
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