NPI age
19 years
Enumerated 2006-12-30
Across 40 active family medicine providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (NV) | 1538225776 | |
| 05 (TX) | 38413304 | |
| 01 | 11997161 | CAQH |
| 05 (TX) | 038413303 | |
| 05 (TX) | 38413305 |
Part of a multi-provider practice. 34 other active providers share this practice address in NPPES.
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