NPI age
19 years
Enumerated 2006-07-20
Across 803 active pain medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 130355404 | |
| 01 | 050012360 | MEDICARE RAILROAD BEFORE 5/27/08 |
| 01 (TX) | 00J04K | BLUE CROSS BLUE SHIELD |
| 01 (TX) | H5592 | STATE LICENSE NUMBER |
| 01 | P00473907 | MEDICARE RAILROAD AFTER 5/27/08 |
Solo or small practice. No other active providers share this practice address in NPPES.
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