NPI age
20 years
Enumerated 2005-06-09
Across 749 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 165809805 | |
| 01 (MO) | 215107 | BLUE CROSS BLUE SHIELD |
| 05 (MO) | 207215203 |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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