NPI age
19 years
Enumerated 2006-10-03
Across 15661 active dentist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 437331 | UNITED CONCORDIA PPO ID # |
| 01 (TX) | D15057 | BLUECROSS BLUESHIELD PPO |
| 01 (TX) | 79608 | DELTA DENTAL PPO ID# |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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