NPI age
19 years
Enumerated 2006-07-27
Across 602 active thoracic surgery (cardiothoracic vascular surgery) providers in Texas.
3 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 114156604 | |
| 01 (TX) | TIN PLUS 039 | TRICARE NORTHPARK LOCATION |
| 01 (TX) | TIN PLUS 107 | TRICARE LAKE STREET LOCATION |
| 01 (TX) | TIN PLUS 110 | TRICARE MAPS LOCATION |
| 05 (TX) | 114156605 | |
| 01 (TX) | G1567 | MEDICAL LICENSE |
| 01 (TX) | 8AM684 | BCBS |
Part of a multi-provider practice. 21 other active providers share this practice address in NPPES.
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