NPI age
20 years
Enumerated 2006-01-27
Across 114 active internal medicine providers in Texas.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 75-2616977-026 | TRICARE |
| 01 (TX) | 752616977001 | TRICARE |
| 05 (SC) | NC1289 | |
| 01 (TX) | 752616977015 | TRICARE |
| 01 (NC) | 2403268 | NC MEDICARE PTAN |
| 01 (TX) | 752616977028 | TRICARE |
| 01 (TX) | 00T71U | BCBS BLUE |
| 05 (NC) | 5915940 | |
| 01 (TX) | 752616977002 | TRICARE |
| 01 (TX) | P01222503 | MEDICARE RR |
| 05 (TX) | 322437001 | |
| 05 (TX) | 322437002 |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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