NPI age
19 years
Enumerated 2006-08-12
Across 2220 active physician assistant providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | PA01750 | STATE PA LICENSE |
| 01 (TX) | 8L27392 | MEDICARE INDIVIDUAL PIN |
Part of a multi-provider practice. 10 other active providers share this practice address in NPPES.
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