NPI age
10 years
Enumerated 2016-05-10
Across 1647 active clinic/center providers in Texas.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 45D2145076 | CLIA ID NUMBER |
| 01 (TX) | 130384 | STATE LICENSE |
| 05 (TX) | 391353501 |
Multi-provider organization. 1 individual provider on file at this primary address.
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