NPI age
20 years
Enumerated 2005-06-28
Across 883 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (OK) | 100033830A | |
| 01 (OK) | 16625 | MEDICAL LICENSURE |
| 05 (TX) | 131311608 |
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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