NPI age
19 years
Enumerated 2006-12-06
Across 689 active clinic/center providers in Texas.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 | 080106971 | RR MEDICARE |
| 01 (TX) | 00258V | MEDICARE PART B PIN |
| 01 (TX) | 0042GW | BCBS |
| 05 (TX) | RO458941 |
Doing-business-as, former, and alternate names recorded by NPPES.
Multi-provider organization. 1 individual provider on file at this primary address.
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