NPI age
19 years
Enumerated 2006-10-24
Across 4038 active specialist providers in Texas.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 40080493 | DPS |
| 01 (TX) | H6759 | TEXAS STATE BOARD OF MEDI |
| 05 (TX) | 128483803 | |
| 01 (TX) | 00K99G | BLUE CROSS BLUE SHEILD |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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