NPI age
20 years
Enumerated 2006-05-11
Across 15966 active family medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | K5471 | TEXAS PERMIT |
| 05 (OK) | 100204190D | |
| 05 (OK) | 100204190B |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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