NPI age
19 years
Enumerated 2006-11-30
Across 935 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 760616728 | TAX ID |
| 01 (TX) | 460003089 | MEDICARE RAILROAD |
| 01 (TX) | 0017EW | BLUE CROSS BLUE SHILED |
| 01 (TX) | 2458724 | AETNA |
| 05 (TX) | 030806601 |
Part of a multi-provider practice. 86 other active providers share this practice address in NPPES.
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