Medical school: UNIVERSITY OF TEXAS MEDICAL SCHOOL AT HOUSTON
Graduated: 2000
NPI: 1003899782
Practice Locations (2)
5802 THUNDERBIRD, APT A
LAGO VISTA, TX 786455887
5802 THUNDERBIRD ST, APT A
LAGO VISTA, TX 786455888
5122675400
Source: CMS National Downloadable File, September 2026.