NPI age
19 years
Enumerated 2006-10-25
Across 3028 active surgery providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TN) | 1518010 | |
| 01 (TX) | 8G1260 | BLUE CROSS,BLUE SHIELD |
| 05 (TX) | 080641601 | |
| 01 (TX) | 760619957 | AETNA |
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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