NPI age
20 years
Enumerated 2006-02-13
Across 957 active podiatrist providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 092751901 | |
| 01 (TX) | 480001643 | MEDICARE RAILROAD |
| 01 (TX) | 480928621 | MEDICARE RAILROAD |
| 01 (TX) | 8AJ312 | BLUE CROSS BLUE SHIELD |
| 01 (TX) | 751523800 | IRS INDIVIDUAL TAXPAYER IDENTIFICATION NUMBER |
| 05 (TX) | 092751902 |
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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