NPI age
17 years
Enumerated 2008-08-12
Across 7055 active pediatrics providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 205044503 | |
| 01 (TX) | N2774 | ST LIC |
| 01 (TX) | 8CS891 | BCBS |
| 01 (TX) | 205044504 | CSN |
Part of a multi-provider practice. 131 other active providers share this practice address in NPPES.
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