NPI age
19 years
Enumerated 2006-06-03
Across 1318 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 145403503 | |
| 05 (TX) | 168067001 | |
| 01 (TX) | 0027LW | BCBS GROUP # |
| 01 (TX) | 8P5490 | BC/BS PIN |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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