NPI age
19 years
Enumerated 2006-07-25
Across 15966 active family medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 176036502 | |
| 01 (TX) | 752616977007 | TRICARE |
| 01 (TX) | 8AS780 | BCBS OF TEXAS |
Part of a multi-provider practice. 20 other active providers share this practice address in NPPES.
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