NPI age
18 years
Enumerated 2007-10-09
Across 4038 active specialist providers in Texas.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | B43852 | UPIN |
| 01 (TX) | 0094MP | BCBS |
| 01 (TX) | 173845201 GRP | TPI |
| 01 (TX) | F7043 | TX LIC |
| 05 (TX) | 173845201 GRP |
Multi-provider organization. 1 individual provider on file at this primary address.
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