NPI age
19 years
Enumerated 2006-11-30
Across 3028 active surgery providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | P02601507 | MCRR |
| 05 (TX) | 345127001 | |
| 01 (TX) | 1K0573 | MEDICARE |
| 05 (TX) | 345127002 |
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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