NPI age
12 years
Enumerated 2014-05-21
Across 15966 active family medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 587636YMAF | MEDICARE |
| 01 (TX) | 75-2616977-028 | TRICARE |
| 01 (TX) | P01878872 | MEDICARE RAIL ROAD |
| 01 (TX) | 374159701 | MEDICAID |
Part of a multi-provider practice. 15 other active providers share this practice address in NPPES.
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