NPI age
19 years
Enumerated 2006-07-28
Across 3028 active surgery providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (OK) | 200076750A | |
| 05 (AR) | 771011301 | |
| 01 (AR) | 5N457 | BLUE CROSS/BLUE SHIELD |
| 01 (AR) | 733616 | HEALTHLINK |
| 05 (AR) | 159335001 | |
| 01 (AR) | 450521250 | CHAMPUS/TRICARE |
| 01 (AR) | 6010014400 | QUALCHOICE |
| 01 (AR) | 8567595 | CIGNA |
Part of a multi-provider practice. 24 other active providers share this practice address in NPPES.
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