NPI age
20 years
Enumerated 2005-07-14
Across 163 active podiatrist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 1712002 01 | |
| 05 (TX) | 1796609 01 | |
| 01 (TX) | 9360728 | PHCS PROVIDER # |
| 05 (TX) | 1796609 02 | |
| 01 (TX) | 201525710 | COMMERCIAL INSURANCE ID # |
| 01 (TX) | 0098LJ | BCBS OF TX PROVIDER 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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