NPI age
18 years
Enumerated 2007-10-05
Across 7055 active pediatrics providers in Texas.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 0087CL | BLUE CROSS BLUE SHIELD |
| 05 (TX) | 111836604 | |
| 01 (TX) | 10049506 | AMERIGROUP |
| 01 (TX) | 5965594 | AETNA |
| 05 (TX) | 111836605 |
Doing-business-as, former, and alternate names recorded by NPPES.
Multi-provider organization. 1 individual provider on file at this primary address.
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