NPI age
20 years
Enumerated 2006-04-11
Across 217 active internal medicine providers in Texas.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 111436508 | |
| 01 | 368120YSCW | MEDICARE PTAN |
Part of a multi-provider practice. 17 other active providers share this practice address in NPPES.
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