NPI age
20 years
Enumerated 2006-05-22
Across 4038 active specialist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 4234288 | AETNA PROVIDER NUMBER |
| 01 (TX) | 040005350 | MEDICARE RAILROAD PIN |
| 01 (TX) | 88X321 | BCBS PROVIDER NUMBER |
Part of a multi-provider practice. 8 other active providers share this practice address in NPPES.
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