NPI age
19 years
Enumerated 2006-12-05
Across 935 active dentist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | T15797 | UPIN |
| 05 (TX) | 126646201 | |
| 01 (TX) | 11854 | LICENSE |
| 05 (TX) | 126646212 | |
| 05 (TX) | 126646211 | |
| 05 (TX) | 126646213 |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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