NPI age
18 years
Enumerated 2007-06-27
Across 4038 active specialist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 1205813888 | GROUP NPI NUMBER |
| 05 (TX) | P000L06R0 |
Part of a multi-provider practice. 35 other active providers share this practice address in NPPES.
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