NPI age
20 years
Enumerated 2005-11-02
Across 7055 active pediatrics providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 451901 | MEDICARE GROUP PTAN |
| 01 (TX) | 130880104 | MEDICAID GROUP |
| 05 (TX) | 127320104 | |
| 01 (TX) | 1831267079 | GROUP NPI |
Part of a multi-provider practice. 224 other active providers share this practice address in NPPES.
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