NPI age
18 years
Enumerated 2007-06-14
Across 3028 active surgery providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 332557301 | |
| 01 (NE) | 6847 | TEMPORARY EDUCATION PERMIT |
| 01 | 3870853755 | MYUTMB 3870853755-COMMERCIAL NUMBER |
| 01 (TX) | P7967 | MEDICAL LICENSE |
Part of a multi-provider practice. 11 other active providers share this practice address in NPPES.
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