NPI age
19 years
Enumerated 2007-03-22
Across 82 active pediatrics providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (NV) | LL1495 | MEDICAL LICENSE |
| 01 (CA) | A99645 | OTHER |
| 05 (TX) | 215601001 |
Part of a multi-provider practice. 1403 other active providers share this practice address in NPPES.
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