NPI age
20 years
Enumerated 2005-12-16
Across 1597 active pathology providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 | 011265L84 | MEDICARE - LGP |
| 01 (VA) | 006600972 | MEDICAID - LGP |
| 05 (VA) | 010273714 |
Solo or small practice. No other active providers share this practice address in NPPES.
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