NPI age
20 years
Enumerated 2006-01-18
Across 7055 active pediatrics providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 154315903 | |
| 05 (TX) | 154315901 | |
| 01 (TX) | 8G3050 | BLUE CROSS |
| 01 (TX) | 75-2616977-027 | TRICARE |
| 01 (TX) | GA179 | BCBS |
| 01 (TX) | P01697213 | RAIL ROAD MEDICARE |
Part of a multi-provider practice. 15 other active providers share this practice address in NPPES.
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