NPI age
19 years
Enumerated 2006-08-12
Across 1890 active physician assistant providers in Texas.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | PA04642 | PA LICENSE |
| 01 (TX) | 8N9750 | BLUE CROSS BLUE SHIELD |
| 05 (TX) | 110400202 |
Part of a multi-provider practice. 6 other active providers share this practice address in NPPES.
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