NPI age
20 years
Enumerated 2006-05-10
Across 4391 active psychiatry & neurology providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 113854702 | |
| 01 (TX) | 752484883 | TAX ID # |
| 01 (TX) | 00A32X | BCBS PROVIDER # |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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