NPI age
13 years
Enumerated 2012-06-08
Across 674 active clinic/center providers in Texas.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (OK) | 29413 | OK MED LICENSE |
| 01 (TX) | N4420 | MEDICAL LICENSE |
Multi-provider organization. 1 individual provider on file at this primary address.
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