NPI age
19 years
Enumerated 2006-09-14
Across 15966 active family medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 0012KA | BLUE CROSS GROUP |
| 01 (TX) | 118973004 | TPI INDIVIDUAL |
| 01 (TX) | 151577701 | TPI GROUP |
| 01 (TX) | J5247 | TEXAS MEDICAL LICENSE # |
Part of a multi-provider practice. 8 other active providers share this practice address in NPPES.
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