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General NPI Number Information
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NPI Number | 1013366483
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Entity Type | Organization
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Legal Business Name | ROBERT E MCDONALD
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Dates
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Enumeration Date | 06/07/2016
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Last Update Date | 06/07/2016
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Provider Practice Location Address
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Address Line | 1740 W 27TH ST STE 315
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City | HOUSTON
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State | TX
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Zip | 77008-1440
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Country | US
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Telephone | 713-864-0533
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Fax | 713-864-6658
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Provider Business Mailing Address
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Address Line | 1740 W 27TH ST STE 315
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City | HOUSTON
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State | TX
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Zip | 77008-1440
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Country | US
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Telephone | 713-864-0533
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Fax | 713-864-6658
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Authorized Official
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Title or Position | SOLE OWNER
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Name | ROBERT E MCDONALD
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Credential | MD
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Telephone | 713-864-0533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | F1798
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License Number State | TX
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