NPI age
19 years
Enumerated 2006-09-28
Across 15966 active family medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 8K4496 | INDIVIDUAL PTAN |
| 01 (TX) | T0150108 | TEXAS CONTROLLED SUBSTANCE |
| 01 (TX) | #8DJ151 | BCBS HMO/PPO PROVIDER ID |
| 05 (TX) | 1846859-09 | |
| 01 (TX) | 00U72Z | GROUP PTAN |
Part of a multi-provider practice. 7 other active providers share this practice address in NPPES.
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