NPI age
20 years
Enumerated 2006-04-20
Across 920 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 177738501 | |
| 01 (TX) | 1143000 | AETNA |
| 01 (TX) | M1510 | STATE LICENSE |
| 01 (TX) | 8J3801 | BLUE CROSS BLUE SHIELD |
| 01 (TX) | MD1510 | WORKERS COMP |
Part of a multi-provider practice. 40 other active providers share this practice address in NPPES.
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