NPI age
20 years
Enumerated 2006-04-03
Across 15966 active family medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 1773269-01 | |
| 01 (TX) | 1773269-02 | CSHCN |
| 01 (TX) | 8S1909 | BLUE SHIELD |
Part of a multi-provider practice. 1981 other active providers share this practice address in NPPES.
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