NPI age
19 years
Enumerated 2006-10-12
Across 6023 active anesthesiology providers in Texas.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 742710179A011 | CHAMPUS |
| 01 (TX) | MDJ0338TX | WORKERS COMPENSATION |
| 05 (TN) | 123558203 |
Part of a multi-provider practice. 72 other active providers share this practice address in NPPES.
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