NPI age
19 years
Enumerated 2007-02-20
Across 11022 active physician assistant providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | PA02057 | TEXAS STATE LICENSE |
| 01 (TX) | P01572426 | RAIL ROAD MEDICARE |
| 01 (TX) | 75-2616977-028 | TRICARE |
| 05 (TX) | 1508901596 |
Part of a multi-provider practice. 36 other active providers share this practice address in NPPES.
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