NPI age
14 years
Enumerated 2011-11-21
Across 422 active clinic/center providers in Texas.
3 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 | K0160 | MEDICAL LICENSE |
| 05 (TX) | 126563902 |
Multi-provider organization. 3 individual providers on file at this primary address.
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