NPI age
20 years
Enumerated 2006-05-18
Across 4391 active psychiatry & neurology providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 8AJ514 | BCBS |
| 01 | P00279334 | MEDICARE RR |
| 01 (TX) | J0038 | STATE LICENSE |
| 05 (TX) | 096815803 |
Part of a multi-provider practice. 14 other active providers share this practice address in NPPES.
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