NPI age
19 years
Enumerated 2006-06-27
Across 1797 active dentist providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 160823409 | |
| 01 (TX) | 21471 | TEXAS DENTAL LICENSE |
| 01 (TX) | 88D731 | BCBS |
| 05 (TX) | 160823403 | |
| 05 (TX) | 160823407 |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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