NPI age
15 years
Enumerated 2010-08-23
Across 15966 active family medicine providers in Texas.
4 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (PA) | 102765640 0002 |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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