NPI age
20 years
Enumerated 2005-09-23
Across 15966 active family medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 197261401 | |
| 01 (TX) | N0337 | TEXAS LICENSE |
| 01 (TX) | 00Z863 | MEDICARE GRP PIN |
| 01 (TX) | 197259801 | MEDICAID GRP |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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