NPI age
20 years
Enumerated 2006-05-18
Across 4038 active specialist providers in Texas.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 1803926-01 | |
| 01 | 0045NH | BCBS |
Multi-provider organization. 1 individual provider on file at this primary address.
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