NPI age
20 years
Enumerated 2006-02-15
Across 383 active pediatrics providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 | 1210079 | IHA |
| 01 | 000524976004 | BC/BS |
| 01 | 00010314402 | UNIVERA |
| 01 | 000524976005 | BC/BS |
| 01 | 040426001459 | FIDELIS |
| 05 (PA) | 0016936150001 | |
| 05 (NY) | 01789679 |
Part of a multi-provider practice. 65 other active providers share this practice address in NPPES.
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