NPI age
19 years
Enumerated 2007-04-11
Across 15966 active family medicine providers in Texas.
20 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 084120701 | TPI NUMBER |
| 01 (TX) | 86W800 | BLUE CROSS RENDERING NO. |
| 05 (TX) | 137945507 | |
| 01 (TX) | 137945510 | EPSDT RENDERING NO. |
| 01 (TX) | 00N25X | BLUE CROSS NO. |
Doing-business-as, former, and alternate names recorded by NPPES.
Multi-provider organization. 20 individual providers on file at this primary address.
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