NPI age
20 years
Enumerated 2005-11-01
Across 4038 active specialist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 071900011 | MEDICARE RAILROAD |
| 01 (TX) | D4148 | TEXAS MEDICAL LICENSE # |
| 01 (TX) | 00N148 | MEDICARE PROVIDER # |
Part of a multi-provider practice. 9 other active providers share this practice address in NPPES.
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