NPI age
20 years
Enumerated 2005-12-14
Across 12343 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | TXB104323 | PTAN |
| 01 (TX) | N1054 | TEXAS MEDICAL BOARD |
| 01 (CA) | 00A79522 | MEDICAL LICENSE |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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