NPI age
20 years
Enumerated 2005-06-21
Across 3028 active surgery providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 1547184-01 | |
| 01 (TX) | 8G8160 | BCBS PROV ID |
| 01 (TX) | 00000021JK | BCBS PROV # |
| 01 (TX) | 751702073 | AETNA PROV # |
| 01 (TX) | 827023082 | RR MEDICARE |
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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