NPI age
19 years
Enumerated 2006-08-11
Across 12343 active internal medicine providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | D9110 | STATE LICENSE |
| 01 (TX) | 1275712572 | GROUP NPI |
| 05 (TX) | 128498605 |
Part of a multi-provider practice. 84 other active providers share this practice address in NPPES.
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