NPI age
18 years
Enumerated 2008-05-16
Across 14 active physical medicine & rehabilitation providers in Texas.
9 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 315115106 | |
| 01 (TX) | 8EA792 | BLUE CROSS BLUE SHIELD |
| 05 (TX) | 315115107 |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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