NPI age
20 years
Enumerated 2005-09-15
Across 4391 active psychiatry & neurology providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (IL) | 01032028 | BCBS |
| 01 (TX) | 1D7195 | MEDICARE |
| 05 (TX) | 412995901 |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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