NPI age
19 years
Enumerated 2006-10-04
Across 7055 active pediatrics providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (AR) | 5M760 | BCBS |
| 05 (AR) | 152142001 | |
| 01 (AR) | 04020015800 | QUALCHOICE |
Part of a multi-provider practice. 71 other active providers share this practice address in NPPES.
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