NPI age
20 years
Enumerated 2005-07-07
Across 15966 active family medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 041005201 | |
| 01 (TX) | 041005202 | MEDICAID TX HEALTHSTEPS |
| 01 (TX) | 82561X | BLUE CROSS BLUE SHIELD |
| 01 (TX) | TXB106274 | PTAN |
| 05 (TX) | 041005202 | |
| 01 | G76542 | UPIN |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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