NPI age
17 years
Enumerated 2008-11-12
Across 729 active pediatrics providers in Texas.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 52457195 | BCBS |
| 01 (GA) | 558108 | WELLCARE |
| 01 (GA) | 3180115 | UHC |
| 01 (GA) | 8723262 | CIGNA |
| 01 (GA) | 01348277 | AMERIGROUP |
| 05 (GA) | 721175404B |
Part of a multi-provider practice. 154 other active providers share this practice address in NPPES.
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