NPI age
19 years
Enumerated 2006-07-10
Across 883 active internal medicine providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (MA) | 110040590 | |
| 05 (TX) | 306991602 | |
| 01 (TX) | 317822YTJC | MEDICARE PTAN |
| 01 (TX) | 317822YTJV | MAEDICARE PTAN |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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