NPI age
15 years
Enumerated 2010-09-02
Across 3379 active specialist/technologist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 207164901 | |
| 05 (TX) | 149984001 |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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