NPI age
19 years
Enumerated 2006-12-21
Across 3776 active radiology providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 033047401 | |
| 01 (TX) | 15654 | AMERIGROUP |
| 01 (TX) | 826302203A | PALMETTO |
| 01 (TX) | 00ET77 | BCBS |
| 01 (TX) | MDD4029 | LIC NUMBER |
Part of a multi-provider practice. 97 other active providers share this practice address in NPPES.
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