NPI age
20 years
Enumerated 2005-07-01
Across 2301 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (LA) | 1683060 | MEDICAID |
| 05 (TX) | 1206179-05 |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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