NPI age
16 years
Enumerated 2009-12-15
Across 15966 active family medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (PA) | 2139334 | HIGHMARK |
| 01 | WL142075 | PASSPORT NUMBER |
Part of a multi-provider practice. 17 other active providers share this practice address in NPPES.
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