NPI age
20 years
Enumerated 2006-05-01
Across 126 active surgery providers in Texas.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | P02587370 | MCRR |
| 05 (TX) | 417623201 |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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