NPI age
18 years
Enumerated 2007-06-12
Across 2078 active community/behavioral health providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 111894502 | |
| 05 (TX) | 111894503 | |
| 05 (TX) | 82A | |
| 05 (TX) | 111894501 |
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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