NPI age
19 years
Enumerated 2006-06-29
Across 81 active otolaryngology providers in Texas.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 | H9304 | STATE LIC |
| 01 | 760388511 | TAX ID |
| 01 (TX) | 00K65F | BLUE CROSS/BLUE SHIELD TX |
| 05 (TX) | 099172103 | |
| 05 (TX) | 099172102 |
Solo or small practice. No other active providers share this practice address in NPPES.
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