NPI age
20 years
Enumerated 2005-06-09
Across 4038 active specialist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 | P00107003 | RR MEDICARE |
| 01 | 78842 | BLUE CROSS |
| 01 | P00085272 | RR MEDICARE |
| 05 (TX) | 204632801 | |
| 01 | ME87364 | WORKER'S COMP |
| 05 (FL) | 268207900 |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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