NPI age
21 years
Enumerated 2005-05-31
Across 293 active physical medicine & rehabilitation providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (OH) | 084321 | STATE MEDICAL BOARD |
| 05 (TX) | 30505403 | |
| 01 (TX) | 8G9346 | MEDICARE ID |
| 01 (TX) | 8X1170 | BLUE CROSS BLUE SHIELD |
Part of a multi-provider practice. 43 other active providers share this practice address in NPPES.
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