NPI age
11 years
Enumerated 2014-08-08
Across 15966 active family medicine providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 415262101 | |
| 05 (TX) | 415262103 | |
| 01 (IL) | 036-143790 | STATE LICENSE |
| 05 (TX) | 415262102 |
Part of a multi-provider practice. 335 other active providers share this practice address in NPPES.
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