NPI age
20 years
Enumerated 2005-12-15
Across 16582 active physical therapist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 | 83705T | BLUE CROSS BLUE SHIELD |
| 01 (TX) | 1088946 | STATE LIC NUMBER |
| 01 (AK) | 125544 | AK LIC NUMBER |
Part of a multi-provider practice. 7 other active providers share this practice address in NPPES.
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