NPI age
19 years
Enumerated 2006-08-23
Across 6039 active emergency medicine providers in Texas.
4 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 176124903 | |
| 01 (TX) | 8S9234 | BCBSTX PROV NO |
| 05 (TX) | 176124902 | |
| 01 (TX) | 1861509473 | TRICARE SOUTH |
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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