NPI age
19 years
Enumerated 2006-12-11
Across 15966 active family medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 045764008 | |
| 05 (TX) | 045764004 | |
| 01 (TX) | PO1224842 | RAILROAD MEDICARE # |
| 01 (TX) | 8DN139 | BCBS # |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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