NPI age
20 years
Enumerated 2005-09-14
Across 4038 active specialist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 00N63L | BCBS |
| 05 (TX) | 035060501 |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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