NPI age
20 years
Enumerated 2006-05-19
Across 920 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 8M8070 | BLUE CROSS BLUE SHIELD |
| 05 (TX) | 116505205 | |
| 01 (TX) | J7966 | MEDICAL LICENSE |
Part of a multi-provider practice. 20 other active providers share this practice address in NPPES.
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