Individual
EMEM IDEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
2600 E PFLUGERVILLE PKWY STE 100, PFLUGERVILLE, TX 78660-5999
(512) 654-6100
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(800) 994-0371
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
P9372
TX
208M00000X
Hospitalist Physician
Primary
3271054
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
341747902
—
TX
05
—
341747903
—
TX
05
—
341747904
—
TX
05
—
341747905
—
TX
01
—
373078YKXV
MEDICARE
TX
01
—
373078YKXY
MEDICARE
TX
01
—
373078YLP1
MEDICARE
TX
01
—
373078YLP2
MEDICARE
TX
Enumeration date
12/17/2009
Last updated
07/23/2025
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