NPI age
5 years
Enumerated 2020-07-16
Across 850 active clinic/center providers in Texas.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 | 11813129 | CAQH |
| 05 (LA) | 1029807 | |
| 01 (LA) | 600712760 | MAGELLAN |
| 01 (NJ) | NJ2611 | BCBS# |
| 01 (LA) | MD.201514 | MD LICENSE |
| 01 (LA) | 418846 | MHN |
Multi-site organization. 2 additional practice locations on file.
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