NPI age
19 years
Enumerated 2006-08-16
Across 9237 active dentist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 25DG | BCBS TX PROVIDER # |
| 01 (TX) | 809903 | UNITED CONCORDIA PROV # |
| 01 (TX) | 84D742 | BCBS PROVIDER # |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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