NPI age
19 years
Enumerated 2006-08-22
Across 15966 active family medicine providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 031355303 | |
| 01 (TX) | 75-2616977-007 | TRICARE |
| 05 (TX) | 031355302 | |
| 01 (TX) | 75-2616977-108 | TRICARE |
| 01 (TX) | 752616977118 | TRICARE |
| 05 (GA) | 460041120A | |
| 01 (TX) | 8DB081 | BCBS |
| 01 (TX) | 8DC095 | BCBS |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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