NPI age
19 years
Enumerated 2006-08-16
Across 12343 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 010029302 | MEDICARE RAIL ROAD # |
| 01 (TX) | 10014906 | AMERIGROUP MEDICAID |
| 05 (TX) | 137970308 | |
| 01 (TX) | 85613Z | BCBS HMO # |
| 01 (TX) | 00D53P | BCBS PPO # |
| 01 (TX) | 76-0367510 | TAX ID # |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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