NPI age
20 years
Enumerated 2006-02-22
Across 2087 active general practice providers in Texas.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 003174806A | |
| 01 (NC) | 1278M | BCBSNC |
| 05 (NC) | 7906805 | |
| 01 (GA) | 202I086108 | MEDICARE PTAN |
Part of a multi-provider practice. 109 other active providers share this practice address in NPPES.
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