NPI age
20 years
Enumerated 2006-02-21
Across 12343 active internal medicine providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (IL) | P00618660 | RR MEDICARE GROUP MEMBER PTAN |
| 05 (IL) | 036093491 | |
| 01 (IL) | 809840 | MEDICARE GROUP PTAN |
| 01 (IL) | CA4079 | RR MEDICARE GROUP PTAN |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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