NPI age
20 years
Enumerated 2005-07-14
Across 15966 active family medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 4387541 | AETNA PROVIDER NUMBER |
| 01 (TX) | 00F35R | BLUE CROSS ID |
| 05 (TX) | 1336208-01 | |
| 05 (TX) | 133620801 |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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