NPI age
20 years
Enumerated 2006-01-23
Across 6039 active emergency medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (IL) | 036098701 | |
| 05 (CA) | 00A812940 | |
| 01 (IL) | 3932056 | BLUE SHIELD |
Part of a multi-provider practice. 23 other active providers share this practice address in NPPES.
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