NPI age
20 years
Enumerated 2005-07-20
Across 568 active radiology providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (SC) | 752268615 | TRICARE/CHAMPUS |
| 01 (TN) | D11H | BLUE CROSS |
| 05 (TX) | 0325987-01 | |
| 01 (AR) | 50979 | BLUE CROSS |
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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