NPI age
19 years
Enumerated 2006-10-04
Across 15966 active family medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 1376170-12 | |
| 01 (TX) | 74287370001 | CHAMPUS |
| 01 (TX) | 00U85N | BLUE CROSS BLUE SHIELD OF |
| 01 (TX) | 742787370 | COMMERCIAL CLAIMS |
Part of a multi-provider practice. 16 other active providers share this practice address in NPPES.
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