NPI age
20 years
Enumerated 2005-12-21
Across 1890 active physician assistant providers in Texas.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (VA) | 010222796 | |
| 01 | 203639329 | TRICARE PROVIDER NUMBER |
Part of a multi-provider practice. 523 other active providers share this practice address in NPPES.
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