NPI age
20 years
Enumerated 2005-12-23
Across 1136 active podiatrist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 045404301 | |
| 05 (TX) | 080689501 | |
| 01 (TX) | 86981S | BCBS PROVIDER NUMBER |
| 01 (TX) | 752774903 | TAX INDENTIFICATION NUMBE |
Part of a multi-provider practice. 27 other active providers share this practice address in NPPES.
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