NPI age
17 years
Enumerated 2008-06-01
Across 383 active pediatrics providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | R4224 | MEDICAL LICENSE |
| 01 (MA) | 232667 | MA MEDICAL LISCENCE |
Part of a multi-provider practice. 43 other active providers share this practice address in NPPES.
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