NPI age
12 years
Enumerated 2013-06-20
Across 7 active dermatology providers in Texas.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 8LL400 | BCBS |
| 05 (TX) | 401042301 | |
| 01 (TX) | 401042302 | CSHCN (MEDICAID) |
Part of a multi-provider practice. 75 other active providers share this practice address in NPPES.
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