NPI age
18 years
Enumerated 2008-01-28
Across 15966 active family medicine providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | M8412 | STATE LI |
| 01 (TX) | Y0156060 | DPS |
| 01 (TX) | 1074235 | PT LICENSE |
Part of a multi-provider practice. 37 other active providers share this practice address in NPPES.
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