NPI age
19 years
Enumerated 2006-08-04
Across 251 active family medicine providers in Texas.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 00919R | MEDICARE ID |
| 01 (TX) | J6747 | LICENSE |
| 01 (TX) | DD9763 | MEDICARE RAILROAD |
| 01 (TX) | 8C0650 | BCBS |
Multi-provider organization. 1 individual provider on file at this primary address.
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