NPI age
19 years
Enumerated 2006-07-10
Across 935 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 0375503 04 | |
| 01 | 8 M2063 | BC/BS |
| 05 (TX) | 037550303 | |
| 01 (TX) | 8J7489 | MEDICARE NUMBER |
| 01 (TX) | 8L10293 | MEDICARE PTAN |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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