NPI age
20 years
Enumerated 2005-12-09
Across 143 active pediatrics providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 10019430 | AMERIGROUP |
| 05 (TX) | 110672603 | |
| 01 (TX) | 8P8930 | BLUE CROSS BLUE SHIELD |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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