NPI age
3 years
Enumerated 2023-01-04
Across 2956 active specialist/technologist providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | AT9121 | STATE LICENSE |
| 01 (TX) | 2000051398 | BOC CERTIFICATION |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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