NPI age
12 years
Enumerated 2013-07-26
Across 7055 active pediatrics providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (CA) | 100011142 | MEDICAL LICENCE NUMBER |
| 05 (TX) | 408640702 | |
| 05 (TX) | 408640703 | |
| 05 (TX) | 408640701 |
Part of a multi-provider practice. 335 other active providers share this practice address in NPPES.
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