NPI age
19 years
Enumerated 2007-02-08
Across 2078 active community/behavioral health providers in Texas.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 000765601 | |
| 05 (TN) | 1477309-01 |
Multi-provider organization. 1 individual provider on file at this primary address.
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