NPI age
16 years
Enumerated 2010-01-04
Across 319 active pain medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | L4376 | TEXAS STATE LICENSE |
| 01 (TX) | 00739V | MEDICARE GROUP # (PTAN) |
Single-site organization. Only one practice location on file.
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