NPI age
19 years
Enumerated 2006-06-17
Across 2956 active specialist/technologist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (OH) | AT-1425 | ATHLETIC TRAINING LICENSE |
| 01 (TX) | AT1929 | ATHLETIC TRAINING LICENSE |
| 01 | 069802392 | NATIONAL CERTIFICATION |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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