NPI age
20 years
Enumerated 2005-07-15
Across 479 active internal medicine providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 364290ZV0W | TX MEDICARE |
| 01 (TX) | 00N64Q | BCBS |
| 01 (TX) | 8U8522 | BLUE CROSS |
| 01 (TX) | G8685 | STATE LICENSE |
| 01 (TX) | P00422917 | RAILROAD MEDICARE |
| 05 (TX) | 133706506 |
Solo or small practice. No other active providers share this practice address in NPPES.
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