Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 2080P0207X | Pediatrics | Pediatric Hematology-Oncology | G4087 | TEXAS | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 134732014 | OTHER | TEXAS | CSHCN LOCALITY 99 |
| 2 | 150220508 | OTHER | TEXAS | MEDICAID GROUP LOCALITY 99 |
| 3 | 150220509 | OTHER | TEXAS | CSHCN LOCALITY 99 |
| 4 | 2599093 | OTHER | TEXAS | CIGNA PIN |
| 5 | 4019271 | OTHER | TEXAS | AETNA PIN |
| 6 | 139314 | OTHER | TEXAS | PHCS PIN |
| 7 | 00257T | OTHER | TEXAS | MEDICARE GROUP LOCALITY 99 |
| 8 | 8L21944 | OTHER | TEXAS | MEDICARE PIN LOCALITY 99 |
| 9 | 40172 | OTHER | TEXAS | FIRSTHEALTH PIN |
| 10 | C13659 | MEDICARE UPIN | TEXAS | |
| 11 | 137345810 | OTHER | TEXAS | CSHCN GROUP |
| 12 | 81X460 | OTHER | TEXAS | BCBSTX IND PIN |
| 13 | 00U87Z | OTHER | TEXAS | MEDICARE GROUP |
| 14 | 8L20082 | MEDICARE PIN | TEXAS | |
| 15 | 10028686 | OTHER | TEXAS | AMERIGROUP PIN |
| 16 | 140442852 | OTHER | TEXAS | MEDICAID GROUP |
| 17 | 60438 | OTHER | TEXAS | UHC PIN |
| 18 | 134732011 | MEDICAID | TEXAS | |
| 19 | 00U87Z | OTHER | TEXAS | BCBSTX GRP PIN |
| 20 | 100707 | OTHER | TEXAS | SUPERIOR PIN |
| 21 | 108985100 | OTHER | TEXAS | FIRSTCARE PIN |
| 22 | 134732012 | OTHER | TEXAS | CSHCN |
| 23 | 134732013 | OTHER | TEXAS | MEDICAID LOCALITY 99 |
