NPI age
17 years
Enumerated 2009-05-04
Across 935 active internal medicine providers in Texas.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 00MA35 | BLUE CROSS BLUE SHIELD |
| 01 (TX) | 8F22034 | INDIVIDUAL PTAN |
| 01 (TX) | 1548494685 | GROUP NPI |
| 01 (TX) | 1750366324 | INDIVIDUAL NPI |
| 01 (TX) | 0A4731 | GROUP PTAN |
| 05 (TX) | 110458002 |
Multi-provider organization. 1 individual provider on file at this primary address.
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