NPI age
12 years
Enumerated 2013-08-15
Across 201 active pediatrics providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (IN) | 201355460 | |
| 01 (IN) | 000001008818 | ANTHEM |
Part of a multi-provider practice. 46 other active providers share this practice address in NPPES.
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