Graduated: 2024
NPI: 1558188482
Practice Locations (2)
PROVIDENCE HEALTH ALLIANCE
301 RICHLAND W CIR, PROVIDENCE INTERNAL MEDICINE CLINIC
WACO, TX 767127932
2545376200
PROVIDENCE HEALTH ALLIANCE
13701 W WOODWAY DR UNIT, 2 ASCENSION MEDICAL GROUP PROVIDENCE
WOODWAY, TX 767123146
2545376900
Source: CMS National Downloadable File, September 2026.