NPI age
16 years
Enumerated 2010-02-16
Across 11022 active physician assistant providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 321033801 | |
| 01 (TX) | 835N10 | BC/BS TX - EFFECT 02/01/2011 |
| 01 (TX) | P00935316 | RAILROAD MEDICARE |
| 01 (TX) | PA06585 | TX MEDICAL LICENSE |
| 01 (TX) | 816N94 | BCBS |
| 01 (TX) | TXB121235 | MEDICARE PART B - EFFECT 02/01/2011 |
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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