NPI age
16 years
Enumerated 2010-03-29
Across 1194 active urology providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | BP10023442 | BASIC PERMIT |
| 01 (TX) | N6066 | TEXAS MEDICAL LICENSE |
| 01 (TX) | P01029717 | RAILROAD MEDICARE |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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