NPI age
20 years
Enumerated 2005-09-14
Across 2155 active ophthalmology providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (CA) | 95-3891546 | TAX IDENTIFICATION NUMBER |
| 01 (TX) | P00098108 | MEDICARE RAILROAD |
| 01 (CA) | G039888 | MEDICAL LICENSE |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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