NPI age
20 years
Enumerated 2005-08-11
Across 100 active preventive medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 1552127-02 | |
| 01 (TX) | 00298U | PTAN |
Part of a multi-provider practice. 40 other active providers share this practice address in NPPES.
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