NPI age
20 years
Enumerated 2005-09-19
Across 957 active podiatrist providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 1636 | LICENSE |
| 05 (TX) | 156579802 | |
| 01 (TX) | P00040744 | MEDICARE RAILROAD |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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