NPI age
19 years
Enumerated 2006-08-19
Across 15966 active family medicine providers in Texas.
5 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | M3476 | TEXAS MEDICAL LICENSE |
| 01 | N0146239 | TX DPS |
| 01 (NM) | MD2005-0204 | NEW MEXICO MEDICAL LIC |
| 01 | 05922968 | ECFMG NUMBER |
Multi-provider organization. 5 individual providers on file at this primary address.
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