NPI age
20 years
Enumerated 2005-10-17
Across 568 active radiology providers in Texas.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (AR) | 143999002 | |
| 01 (TX) | J5500 | MEDICAL LICENSE |
| 01 (TX) | A001 | TRICARE |
Multi-provider organization. 1 individual provider on file at this primary address.
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