NPI age
20 years
Enumerated 2006-04-10
Across 12343 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 0408205-01 | |
| 01 (TX) | 110211298 | RR/MEDICARE |
| 05 (TX) | 040820502 | |
| 01 (TX) | 752616977118 | TRICARE |
| 01 (TX) | 88485Q | BCBS |
Part of a multi-provider practice. 17 other active providers share this practice address in NPPES.
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