NPI age
20 years
Enumerated 2005-07-12
Across 15966 active family medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 | 080187389 | MEDICARE RAILROAD |
| 01 (TX) | 0076EG | BCBS |
| 01 (TX) | 0088MC | BCBS GROUP ID |
| 01 (TX) | J8726 | STATE LICENSE |
Part of a multi-provider practice. 7 other active providers share this practice address in NPPES.
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