NPI age
20 years
Enumerated 2006-02-16
Across 15966 active family medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 75-2616977-066 | TRICARE |
| 05 (TX) | 133466601 |
Part of a multi-provider practice. 26 other active providers share this practice address in NPPES.
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