NPI age
19 years
Enumerated 2006-07-20
Across 7055 active pediatrics providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 10028445 | AMERIGROUP |
| 01 (TX) | 0040GG | BLUE CROSS BLUE SHIELD |
| 05 (TX) | 112008101 |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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