NPI age
19 years
Enumerated 2007-01-05
Across 15966 active family medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 0063DH | BCBS PROVIDER NO. |
| 01 (TX) | 760596382 | TAX ID |
| 05 (TX) | 135189206 |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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