NPI age
20 years
Enumerated 2005-09-23
Across 1024 active otolaryngology providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 00Z738 | MEDICARE GROUP PIN |
| 01 (TX) | 198437901 | MEDICAID GROUP |
| 05 (TX) | 198438701 | |
| 01 (TX) | K4763 | TX LICENSE |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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