NPI age
19 years
Enumerated 2007-04-06
Across 204 active preventive medicine providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (OH) | 34003169 | LICENSE NUMBER OHIO |
| 05 (OH) | 06253415 | |
| 01 (TX) | N6503 | TEXAS LICENSE |
| 01 (TX) | V0174052 | DPS TEXAS |
Part of a multi-provider practice. 18 other active providers share this practice address in NPPES.
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