NPI age
19 years
Enumerated 2006-11-13
Across 15966 active family medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 8P9780 | BLUE CROSS |
| 01 (TX) | L1804 | LICENSE |
| 05 (TX) | 148154106 | |
| 01 (TX) | T0119526 | DPS |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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