NPI age
15 years
Enumerated 2011-05-27
Across 12343 active internal medicine providers in Texas.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (IL) | 206147 | MEDICARE PTAN (GROUP) |
| 01 (IL) | 036135426 | MEDICAID |
| 01 (IL) | F400162299 | MEDICARE PTAN (INDIVIDUAL) |
Part of a multi-provider practice. 194 other active providers share this practice address in NPPES.
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