NPI age
19 years
Enumerated 2006-09-16
Across 920 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 38700301 | |
| 01 (TX) | 110171064 | RR MEDICARE |
| 01 (TX) | 82158S | BCBS |
| 01 (TX) | 038700302 | MEDICAID-CSHCN |
Part of a multi-provider practice. 3675 other active providers share this practice address in NPPES.
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