NPI age
15 years
Enumerated 2010-07-31
Across 7055 active pediatrics providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (VA) | 0101254197 | LICENSE |
| 01 (TX) | Q5116 | LICENSE |
| 05 (TX) | 1518550474 |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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