NPI age
13 years
Enumerated 2012-07-16
Across 4038 active specialist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 | X0183272 | CONTROLLED SUBSTANCE |
| 01 (TX) | PO532 | STATE LICENSE |
| 01 | 1053382937 | INDIVIDUAL NPI |
Single-site organization. Only one practice location on file.
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