NPI age
18 years
Enumerated 2008-01-11
Across 2087 active general practice providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 364078YS33 | MEDICARE PTAN |
| 05 (TX) | 310510803 |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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