NPI age
19 years
Enumerated 2006-07-12
Across 278 active preferred provider organization providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 00B85Q | MEDICARE PART B |
| 05 (TX) | 092496102 | |
| 05 (TX) | 138760721 |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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