NPI age
17 years
Enumerated 2009-04-01
Across 7055 active pediatrics providers in Texas.
19 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | L9777 | TEXAS STATE LICENSE |
| 05 (TX) | 166514302 |
Doing-business-as, former, and alternate names recorded by NPPES.
Multi-provider organization. 19 individual providers on file at this primary address.
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