NPI age
19 years
Enumerated 2007-05-30
Across 309 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 8DM452 | BCBS INDIVIDUAL |
| 05 (TX) | 2815631-02 | |
| 01 (TX) | N1372 | TEXAS MEDICAL LICENSE |
Part of a multi-provider practice. 670 other active providers share this practice address in NPPES.
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