NPI age
14 years
Enumerated 2011-06-10
Across 15966 active family medicine providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 1L8412 | MEDICARE |
| 01 (TX) | P02604877 | RR MCR |
| 05 (TX) | 324380002 |
Part of a multi-provider practice. 7 other active providers share this practice address in NPPES.
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