NPI age
14 years
Enumerated 2011-06-04
Across 52 active psychiatry & neurology providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | BP10039700 | TEXAS MEDICAL BOARD PHYSICIAN IN TRAINING PERMIT |
| 01 (TX) | Q8509 | TEXAS MEDICAL BOARD |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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