NPI age
19 years
Enumerated 2006-11-01
Across 15661 active dentist providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 22854 | TX LICENSE |
| 01 (AR) | 1746328 | UNITED CONCORDIA |
| 01 (AR) | 5Y565 | BCBS |
Part of a multi-provider practice. 6 other active providers share this practice address in NPPES.
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