NPI age
20 years
Enumerated 2005-06-13
Across 4038 active specialist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | X0027046 | DPS LICENSE |
| 01 (TX) | 00BJ45 | BCBS |
| 01 (TX) | P00184518 | MEDICARE RAILROAD |
| 05 (TX) | 130534404 | |
| 01 (TX) | 4295761 | AETNA |
| 01 (TX) | E4545 | MEDICAL LICENSE |
Part of a multi-provider practice. 40 other active providers share this practice address in NPPES.
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