NPI age
19 years
Enumerated 2006-06-03
Across 128 active oral & maxillofacial surgery providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 | 190009680 | RR MDCR |
| 05 (TX) | 110909203 | |
| 01 | 84D155 | BCBS |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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