NPI age
19 years
Enumerated 2006-10-19
Across 625 active dentist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 167216401 | |
| 01 | 89D018 | BLUE CROSS BLUE SHIELD |
| 01 (TX) | 167216401 | CIDC |
| 01 | 1691076 | UNITED CONCORDIA |
Part of a multi-provider practice. 1403 other active providers share this practice address in NPPES.
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