NPI age
19 years
Enumerated 2006-06-04
Across 1136 active podiatrist providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 112200402 | |
| 01 (TX) | 00DC69 | BLUE CROSS BLUE SHIELD OF TEXAS |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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