NPI age
19 years
Enumerated 2006-08-09
Across 15966 active family medicine providers in Texas.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 84750N | BCBS |
| 01 (TX) | 092320302 | EPSDT |
| 01 (TX) | H6573 | STATE LICENSE |
| 05 (TX) | 092320301 | |
| 01 (TX) | 123196100 | VALLEY HEALTH PLAN |
Doing-business-as, former, and alternate names recorded by NPPES.
Multi-provider organization. 1 individual provider on file at this primary address.
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