NPI age
19 years
Enumerated 2006-12-13
Across 59 active neuromusculoskeletal medicine & omm providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 150406002 | |
| 01 (TX) | MDL2139 | WORKER'S COMPENSATION NO |
| 01 (TX) | 00000010JU | BCBS IND # |
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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