Medical school: UNIVERSITY OF TEXAS MEDICAL SCHOOL AT HOUSTON
Graduated: 1994
NPI: 1295709319
Practice Locations (2)
LEGACY HEALTHCARE SERVICES INC
5400 LAUREL LAKE DR
WACO, TX 767102835
2543996633
PROVIDENCE HEALTH ALLIANCE
6101 WOODWAY DR, 230 PROVIDENCE PEDIATRIC CLINIC
WACO, TX 767126117
2545376400
Source: CMS National Downloadable File, September 2026.