NPI age
17 years
Enumerated 2009-03-28
Across 81 active internal medicine providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (IL) | Y21272079165 | DRIVERS LICENSE |
| 01 (MA) | S95886518 | DRIVERS LICENSE |
Part of a multi-provider practice. 22 other active providers share this practice address in NPPES.
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