NPI age
19 years
Enumerated 2006-07-21
Across 12343 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 034049902 | |
| 01 | 1609896497 | INDIVIDUAL NPI |
| 01 (TX) | TXB158053 | MEDICARE |
| 01 (TX) | J2678 | TX MEDICAL BOARD LICENSE |
Part of a multi-provider practice. 18 other active providers share this practice address in NPPES.
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