NPI age
20 years
Enumerated 2006-02-03
Across 947 active neurological surgery providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | J1040 | STATE LICENSE |
| 01 (TX) | 84021B | BCBS # |
| 05 (TX) | 136244401 | |
| 01 (TX) | 4266316 | AETNA |
Part of a multi-provider practice. 12 other active providers share this practice address in NPPES.
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