NPI age
19 years
Enumerated 2006-08-10
Across 7055 active pediatrics providers in Texas.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 488962 | MEDICARE PART B |
| 05 (TX) | 111931501 | |
| 01 (TX) | 0021DU | BCBS |
Multi-provider organization. 1 individual provider on file at this primary address.
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