NPI age
19 years
Enumerated 2007-03-22
Across 15966 active family medicine providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 092291603 | |
| 01 (TX) | 1356468839 | AMERIGROUP |
| 01 (TX) | 1558380790 | AMERIGROUP |
| 05 (TX) | 183751001 |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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