NPI age
20 years
Enumerated 2005-06-16
Across 803 active pain medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 00318V | PTAN |
| 01 (TX) | 00U37Y | BC/BS PROVIDER # |
| 05 (TX) | 1608366-01 | |
| 01 (TX) | 355767400 | U.S. DEPARTMENT OF LABOR# |
| 01 (TX) | 29479 | AMERIGROUP PROVIDER # |
| 01 (TX) | P00035803 | MEDICARE R/R # |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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