NPI age
19 years
Enumerated 2006-09-16
Across 15966 active family medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | H5753 | TX LICENSE |
| 01 (TX) | PO1477395 | RR MEDICARE |
| 05 (TX) | 139144317 |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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