NPI age
20 years
Enumerated 2006-05-16
Across 3776 active radiology providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (MS) | 516561116 | BCBS |
| 01 | 10841377 | CAQH |
| 05 (MN) | 868160100 | |
| 05 (MO) | 204849418 |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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