NPI age
20 years
Enumerated 2005-06-01
Across 237 active clinic/center providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 0308DC | BCBS PROV # |
| 01 | 242880 | AMERIGROUP |
| 01 | 7907597 | AETNA/MEDSOLUTIONS |
Single-site organization. Only one practice location on file.
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