Internal Medicine, Critical Care Medicine · 207RC0200X
Address on file
400 N Saint Paul St Dallas, TX 75201-3114 (972) 449-0540
Enumerated
Jun 8, 2012
Record last updated
Sep 13, 2018
License states listed
TX
Medicare (CMS)
Enrollment
Medicare-enrolled in AL, AR, AZ, CA, CO, DC, FL, GA, IN, KS, KY, MD, ME, MO, MT, NC, NM, NV, NY, OH, OK, SC, TX, VA, WA Critical Care (Intensivists), Internal Medicine
Updated August 2026. Practice locations and specialty come from the CMS Doctors and Clinicians file, the registry record from NPPES, and enrollment from CMS Medicare enrollment files. NPI records are corrected at the source, through NPPES.