NPI age
20 years
Enumerated 2006-05-12
Across 12343 active internal medicine providers in Texas.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | T9601 | |
| 01 (WV) | S0413253 | MEDICARE |
| 05 (KY) | 64013253 | |
| 01 (WV) | 6000592001 | MEDICAID |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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