NPI age
20 years
Enumerated 2006-02-21
Across 7055 active pediatrics providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 752616977004 | TRICARE |
| 01 (TX) | 7166388 | AETNA |
| 01 (TX) | 8G0380 | BCBS OF TEXAS |
| 05 (TX) | 150725301 | |
| 05 (TX) | 150725302 |
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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