NPI age
18 years
Enumerated 2007-07-10
Across 12343 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 | 381870664 | TAX ID |
| 05 (MI) | 1932307097 | |
| 01 (MI) | 700G360210 | BLUE CARE NETWORK |
| 01 (MI) | 7462944 | AETNA |
| 01 (MI) | 700G360210 | BLUE CROSS BLUE SHIELD |
| 01 (MI) | SV083452 | STATE LICENSE |
Part of a multi-provider practice. 132 other active providers share this practice address in NPPES.
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