NPI age
15 years
Enumerated 2010-09-22
Across 12343 active internal medicine providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (MI) | 4301104108 | STATE LICENSE |
| 05 (GA) | 003208359A |
Part of a multi-provider practice. 6 other active providers share this practice address in NPPES.
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