NPI age
20 years
Enumerated 2006-02-17
Across 15966 active family medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 8S3138 | BCBS |
| 01 (TX) | 752616977073 | TRICARE |
| 01 (TX) | TIN | TRICARE |
| 05 (TX) | 121503005 | |
| 01 (TX) | 124499 | SUPERIOR HEALTH - CHIPS |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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