NPI age
20 years
Enumerated 2005-06-23
Across 15966 active family medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 170666501 | |
| 01 | 8M8351 | BCBS |
| 01 | 7311578 | AETNA |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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