NPI age
20 years
Enumerated 2006-05-15
Across 309 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 310501YT79 | MEDICARE |
| 05 (TX) | 1050387-01 | |
| 01 (TX) | 86466K | BCBS |
| 01 (TX) | 10032328 | AMERIGROUP |
| 05 (TX) | 1050387-02 | |
| 01 (TX) | 5919753 | AETNA PROVIDER ID |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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