NPI age
20 years
Enumerated 2006-05-11
Across 883 active internal medicine providers in Texas.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 1558264-02 | |
| 01 (TX) | 10008961 | AMERIGROUP |
| 05 (TX) | 1558264-01 | |
| 01 | 7462025 | AETNA PROVIDER ID |
| 01 (TX) | 8G2851 | BCBS |
Part of a multi-provider practice. 19 other active providers share this practice address in NPPES.
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