NPI age
20 years
Enumerated 2006-01-10
Across 113 active pediatrics providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (OK) | 200058870A | |
| 05 (TX) | 176730301 |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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