NPI age
19 years
Enumerated 2006-07-20
Across 12343 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (CA) | 00A942950 | |
| 01 (TX) | 094010801 | GROUP MEDICAID |
| 01 (TX) | 00J21A | GROUP MEDICARE PIN |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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