NPI age
15 years
Enumerated 2011-04-19
Across 4391 active psychiatry & neurology providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 | 671835 | LEGACY SITE SPECIFIC MEDICARE # |
| 01 (TX) | Q4565 | TEXAS MEDICAL LICENSE |
| 01 (TX) | 08060462703 | LEGACY MEDICIAID # |
Part of a multi-provider practice. 137 other active providers share this practice address in NPPES.
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