NPI age
20 years
Enumerated 2006-04-10
Across 1136 active podiatrist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 00A35L | BLUE CROSS BLUE SHIELD |
| 01 (TX) | 4651102 | AETNA |
| 05 (TX) | 092750101 | |
| 05 (TX) | 092750102 | |
| 01 (TX) | 752573608 | TAX ID |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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