NPI age
19 years
Enumerated 2006-11-05
Across 15966 active family medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 146609602 | THSTEP |
| 01 | H0000006HP | BLUE CROSS BLUE SHIELD |
| 05 (TX) | 146609601 | |
| 01 (TX) | 752949110 | TAX ID |
| 01 (TX) | 2706801 | AETNA |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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