NPI age
20 years
Enumerated 2005-08-02
Across 15966 active family medicine providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 1286064-06 | |
| 01 (TX) | 127101 | SUPERIOR |
| 01 (TX) | 0011KW | BLUECROSS BLUESHIELD |
| 01 (TX) | 1286064-07 | MEDICAID THSTEPS |
| 01 | P00166344 | MEDICARE RAILROAD |
Solo or small practice. No other active providers share this practice address in NPPES.
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