NPI age
18 years
Enumerated 2007-06-13
Across 223 active surgery providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 8FK213 | BCBS |
| 01 (TX) | 8GD975 | BCBS |
| 05 (TX) | 205095705 | |
| 05 (TX) | 205095704 | |
| 01 (TX) | N4049 | STATE LICENSE |
| 05 (TX) | 205095701 | |
| 05 (TX) | 205095702 |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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