NPI age
19 years
Enumerated 2006-12-28
Across 4038 active specialist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 610541200 | DOL |
| 05 (TX) | 176468001 | |
| 01 | 00035Z | MEDICARE GROUP |
| 01 | 0031MS | BCBS |
Single-site organization. Only one practice location on file.
Subpart of Lakewood Orthopaedics & Sports Medicine.
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