NPI age
19 years
Enumerated 2006-11-11
Across 377 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 113654105 | |
| 01 (TX) | 0068AA | BLUE CROSS BLUE SHIELD |
| 01 (TX) | 110141641 | RAILROAD MEDICARE |
| 05 (TX) | 113654104 |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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