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General NPI Number Information
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NPI Number | 1023027026
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Entity Type | Organization
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Legal Business Name | OMEGA PROVIDER SERVICES INC
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 04/23/2012
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Provider Practice Location Address
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Address Line | 2300 VALLEY VIEW LN SUITE 619
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City | IRVING
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State | TX
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Zip | 75062-1721
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Country | US
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Telephone | 817-728-5590
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Fax | 817-728-5599
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Provider Business Mailing Address
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Address Line | 2300 VALLEY VIEW LN SUITE 619
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City | IRVING
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State | TX
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Zip | 75062-1721
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Country | US
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Telephone | 817-728-5590
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Fax | 817-728-5599
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. NGOZI MAY MBAKWE
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Credential |
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Telephone | 817-728-5590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 010465
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License Number State | TX
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