NPI age
17 years
Enumerated 2008-07-01
Across 4391 active psychiatry & neurology providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 138708613 | |
| 01 (TX) | 00R945 | MEDICARE TX |
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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