NPI age
19 years
Enumerated 2006-08-02
Across 2155 active ophthalmology providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 00G65E | BLUE CROSS BLUE SHIELD |
| 01 (TX) | 742595954 | TAX ID |
| 05 (TX) | 130372907 |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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