NPI age
19 years
Enumerated 2007-05-21
Across 1582 active internal medicine providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (KY) | 3525755000 | PASSPORT ADVANTAGE |
| 01 (KY) | 50033376 | PASSPORT/PASSPORT ADVANTAGE |
| 01 (KY) | 000000569234 | ANTHEM |
| 05 (IN) | 200903590 | |
| 05 (KY) | 7100042940 | |
| 01 (KY) | 50019467 | PASSPORT |
| 05 (TX) | 381147301 |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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