NPI age
18 years
Enumerated 2007-07-23
Across 1807 active internal medicine providers in Texas.
18 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 8981 | STATE LICENSE |
| 01 (TX) | CJ2572 | MEDICARE RR |
| 01 (TX) | 00HV34 | BCBS |
| 05 (TX) | 109472403 | |
| 01 (TX) | 7645694 | AETNA |
Multi-provider organization. 18 individual providers on file at this primary address.
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