NPI age
17 years
Enumerated 2008-12-27
Across 1069 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 204293904 | |
| 01 (TX) | 8L14250 | MEDICARE PTAN |
| 01 (TX) | 1811133697 | BLUE CROSS BLUE SHIELD |
| 01 (TX) | P01120352 | RR MEDICARE |
| 05 (TX) | 204293903 |
Part of a multi-provider practice. 37 other active providers share this practice address in NPPES.
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