Medical school: UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
Graduated: 1990
NPI: 1932173044
Practice Locations (2)
PROVIDENCE HEALTH ALLIANCE
6101 WOODWAY DR, 200 PROVIDENCE FAMILY HEALTH CLINIC
WACO, TX 767126117
2545376300
7003 WOODWAY DR, SUITE 306
WOODWAY, TX 767126163
2542248050
Source: CMS National Downloadable File, September 2026.