NPI age
13 years
Enumerated 2012-07-13
Across 201 active pediatrics providers in Texas.
3 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | P1647 | TX MEDICAL LICENSE NUMBER |
Part of a multi-provider practice. 10 other active providers share this practice address in NPPES.
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