NPI age
20 years
Enumerated 2005-06-21
Across 7055 active pediatrics providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (WI) | 004000263A | HUMANA |
| 05 (WI) | 34156200 | |
| 01 (WI) | 7767338 | AETNA |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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