NPI age
20 years
Enumerated 2005-06-13
Across 152 active pediatrics providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (LA) | 1550108 | |
| 01 (LA) | G7577 | BLUE CROSS/BLUE SHIELD |
| 05 (TX) | 290276901 |
Part of a multi-provider practice. 7 other active providers share this practice address in NPPES.
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