NPI age
20 years
Enumerated 2006-05-30
Across 2220 active physician assistant providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (IL) | 209119 | MEDICARE PTAN LOCALITY 16 |
| 01 (IL) | 209118 | MEDICARE PTAN LOCALITY 15 |
Part of a multi-provider practice. 16 other active providers share this practice address in NPPES.
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