NPI age
17 years
Enumerated 2008-07-09
Across 7055 active pediatrics providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 084249401 | GROUP MEDICAID |
| 05 (TX) | 285536301 | |
| 01 (TX) | 00N59X | BCBS |
| 01 (TX) | 1932210838 | GROUP TPI |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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