NPI age
19 years
Enumerated 2006-07-18
Across 100 active preventive medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 125858404 | |
| 01 (TX) | 88Y442 | BCBS |
Part of a multi-provider practice. 11 other active providers share this practice address in NPPES.
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