NPI age
20 years
Enumerated 2005-07-22
Across 7055 active pediatrics providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 710884482 | HUMANA/MILITARY-TRICARE |
| 01 (TX) | 0038AC | BCBS OF TEXAS |
| 05 (TX) | 092090201 | |
| 01 (TX) | 092090202 | MCD EPSDT |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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