NPI age
19 years
Enumerated 2006-06-20
Across 116 active physical medicine & rehabilitation providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 1278600001 | MEDICARE SUPPLIER NUMBER |
| 05 (TX) | 149109402 | |
| 01 (TX) | L2246 | TEXAS MEDICAL BOARD |
Part of a multi-provider practice. 25 other active providers share this practice address in NPPES.
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