NPI age
20 years
Enumerated 2006-03-08
Across 15966 active family medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | Q0814 | TEXAS MEDICAL BOARD |
| 01 (VA) | 010158360 | STATE MEDICAL LICENSE |
| 01 (AR) | E-8688 | STATE LICENSE ARKANSAS |
| 01 (PA) | MD061431Y | STATE LICENSE |
Solo or small practice. No other active providers share this practice address in NPPES.
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