NPI age
10 years
Enumerated 2015-06-19
Across 15661 active dentist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 3553547-01 | MEDICAID EHR TYPR TPI # |
| 01 (UT) | 194264305 | DRIVERS LICENSE |
| 01 (TX) | 0000000000 | MEDICARE ORDER & REFER ONLY |
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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