NPI age
19 years
Enumerated 2007-02-16
Across 7055 active pediatrics providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 092158701 | |
| 05 (TX) | 092158703 | |
| 05 (TX) | 092158702 | |
| 01 (TX) | 751791138 | PROVIDERS TAX ID |
| 01 (TX) | 00NC59 | BCBS |
Solo or small practice. No other active providers share this practice address in NPPES.
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