NPI age
17 years
Enumerated 2008-10-07
Across 1069 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 109514302 | |
| 01 (TX) | 00U40Q | BCBS OF TX |
Doing-business-as, former, and alternate names recorded by NPPES.
Single-site organization. Only one practice location on file.
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