NPI age
20 years
Enumerated 2005-08-03
Across 4038 active specialist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 035735201 | |
| 01 (TX) | 8B4830 | BC/BS |
Part of a multi-provider practice. 87 other active providers share this practice address in NPPES.
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