NPI age
19 years
Enumerated 2006-07-09
Across 62 active psychiatry & neurology providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | L2914 | TX LICENSE |
| 05 (TX) | 149254801 | |
| 01 (TX) | 0018HQ | BCBS |
| 01 (TX) | 8F6600 | BCBS |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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