NPI age
19 years
Enumerated 2007-02-04
Across 163 active podiatrist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 1621 | TX STATE LICENSE NUMBER |
| 01 (TX) | P00217354 | MEDICARE RAILROAD CARRIER |
| 01 (TX) | 8D3049 | MEDICARE PROVIDER ID |
| 01 (TX) | 0053JB | BLUE CROSS BLUE SHIELD ID |
| 01 (TX) | 00393Y | MEDICARE GROUP ID |
Single-site organization. Only one practice location on file.
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