NPI age
19 years
Enumerated 2006-12-14
Across 1318 active internal medicine providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (CA) | A97936 | MEDICAL LICENSE |
| 01 (TX) | Q7400 | TEXAS MEDICAL LICENSE |
| 01 (LA) | MD 204535 | STATE MEDICAL BOARD |
Part of a multi-provider practice. 106 other active providers share this practice address in NPPES.
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