NPI age
20 years
Enumerated 2005-11-08
Across 920 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | S4850 | STATE LICENSE |
| 05 (IN) | 200052750B |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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