NPI age
19 years
Enumerated 2006-08-11
Across 883 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 094010801 | MEDICAID GROUP NUMBER |
| 05 (TX) | 164601003 | |
| 01 (TX) | 00J21A | MEDICARE GROUP NUMBER |
Part of a multi-provider practice. 32 other active providers share this practice address in NPPES.
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