NPI age
19 years
Enumerated 2006-09-20
Across 957 active podiatrist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 147117902 | |
| 01 (TX) | 51KM | BLUE CROSS BLUE SHIELD |
| 01 (TX) | 10012478 | AMERIGROUP |
Part of a multi-provider practice. 6 other active providers share this practice address in NPPES.
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