NPI age
16 years
Enumerated 2010-05-14
Across 7055 active pediatrics providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 | 8CR137 | BCBS TX |
| 01 (TX) | 212706002 | CSN |
| 01 (TX) | N5644 | TEXAS MEDICAL LICENSE |
| 05 (TX) | 212706001 |
Part of a multi-provider practice. 131 other active providers share this practice address in NPPES.
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