Medical school: TEXAS A & M UNIVERSITY SYSTEM, HSC, COLLEGE OF MEDICINE
Graduated: 1997
NPI: 1083688964
Practice Locations (1)
PROVIDENCE HEALTH ALLIANCE
6101 WOODWAY DR, 200 PROVIDENCE FAMILY HEALTH CLINIC
WACO, TX 767126117
2545376300
Source: CMS National Downloadable File, September 2026.