NPI age
19 years
Enumerated 2007-04-20
Across 422 active clinic/center providers in Texas.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 176341901 | |
| 05 (TX) | 176341902 | |
| 01 (TX) | 0076MW | BLUE SHIELD |
Multi-provider organization. 1 individual provider on file at this primary address.
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