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 | 2080P0210X | Pediatrics | Pediatric Nephrology | D6930 | 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 | 378120 | OTHER | TEXAS | PHCS PIN |
| 2 | 10028697 | OTHER | TEXAS | AMERIGROUP PIN |
| 3 | 1416412 | OTHER | TEXAS | FIRSTHEALTH PIN |
| 4 | 4605937 | OTHER | TEXAS | CIGNA PIN |
| 5 | 4243069 | OTHER | TEXAS | AETNA PIN |
| 6 | 87Y110 | OTHER | TEXAS | BCBSTX IND PIN |
| 7 | 124027 | OTHER | TEXAS | SUPERIOR PIN |
| 8 | 137831707 | OTHER | TEXAS | CSHCN IND TPI NUMBER |
| 9 | D04302 | MEDICARE UPIN | | |
| 10 | 138412511 | MEDICAID | TEXAS | |
| 11 | 00U87Z | OTHER | TEXAS | BCBSTX GRP PIN |
| 12 | 107700100 | OTHER | TEXAS | FIRSTCARE PIN |
| 13 | 8288B0 | MEDICARE ID-TYPE UNSPECIFIED | TEXAS | IND MEDICARE |
| 14 | 822100 | OTHER | TEXAS | UHC PIN |
| 15 | 00147T | MEDICARE ID-TYPE UNSPECIFIED | TEXAS | GRP MEDICARE |
| 16 | 137831709 | MEDICAID | TEXAS | |
| 17 | 140442854 | MEDICAID | TEXAS | |
