NPI age
20 years
Enumerated 2005-09-09
Across 4038 active specialist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 0095CL | BLUE CROSS BLUE SHIELD |
| 01 (NM) | J3115 | MEDICAID NEW MEXICO |
Solo or small practice. No other active providers share this practice address in NPPES.
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