NPI age
20 years
Enumerated 2005-12-16
Across 4391 active psychiatry & neurology providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 128324402 | |
| 01 (TX) | 00H80L | BCBS OF TX # |
| 01 | 84-0851219 | TAX ID # |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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