NPI age
20 years
Enumerated 2006-03-23
Across 7055 active pediatrics providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 1507048-01 | |
| 01 (TX) | 8F5576 | BLUE SHIELD |
| 01 (TX) | 1507048-02 | CSHCN |
| 01 (TX) | 370021046 | RR/MEDICARE |
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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