NPI age
19 years
Enumerated 2006-06-24
Across 2301 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | G9602 | TEXAS STATE LICENSE |
| 01 (TX) | 30068526 | DPS |
| 05 (TX) | 080242301 |
Part of a multi-provider practice. 14 other active providers share this practice address in NPPES.
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