NPI age
17 years
Enumerated 2009-03-16
Across 251 active family medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (CO) | 11329777 | |
| 01 (CO) | COA107696 | MEDICARE PTAN |
Part of a multi-provider practice. 958 other active providers share this practice address in NPPES.
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