NPI age
20 years
Enumerated 2005-11-07
Across 3776 active radiology providers in Texas.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 8BJ664 | BCBS |
| 05 (GA) | 000728351Q | |
| 01 (GA) | 52614708 012 | BCBS |
| 05 (CO) | 9000236416 |
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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