NPI age
20 years
Enumerated 2005-06-20
Across 4391 active psychiatry & neurology providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 760129220 | COMMERCIAL |
| 01 (TX) | 0003JT | BLUE CROSS BLUE SHIELD |
| 01 (TX) | 76012922077964A001 | TRICARE |
| 01 (TX) | 0003JT | BLUECROSS/SHIELD GROUP ID |
| 05 (TX) | 144710401 | |
| 01 (TX) | E9541 | UNICARE CLASSIC |
| 01 (TX) | B21268 | OTHER GROUP ID |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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