NPI age
20 years
Enumerated 2006-04-19
Across 729 active pediatrics providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 8J0028 | BCBS |
| 05 (TX) | 1719692-01 | |
| 05 (TX) | 1719692-02 |
Part of a multi-provider practice. 23 other active providers share this practice address in NPPES.
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