NPI age
12 years
Enumerated 2014-05-07
Across 1890 active physician assistant providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 341908701 | |
| 01 (IL) | 085004933 | STATE LICENSE |
Part of a multi-provider practice. 23 other active providers share this practice address in NPPES.
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