NPI age
15 years
Enumerated 2010-10-21
Across 2087 active general practice providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 1312449 | |
| 01 | 00TX44 | BLUE SHIELD |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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