NPI age
19 years
Enumerated 2006-09-28
Across 9237 active dentist providers in Texas.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 009033401 | |
| 05 (TX) | 133270208 | |
| 01 (TX) | D15197 | BLUE CROSS BLUE SHIELD |
Part of a multi-provider practice. 8 other active providers share this practice address in NPPES.
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