NPI age
19 years
Enumerated 2007-05-14
Across 319 active pain medicine providers in Texas.
4 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (AZ) | 223656 | |
| 01 (TX) | 75-2616977-042 | TRICARE TMFH |
| 05 (TX) | 193219602 | |
| 01 (TX) | 8CU877 | BCBS |
| 01 (TX) | 75-2616977-103 | TRICARE |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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