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General NPI Number Information
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NPI Number | 1023383270
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Entity Type | Organization
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Legal Business Name | LIFEPOST MEDICAL CLINIC, INC
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Dates
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Enumeration Date | 03/20/2012
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Last Update Date | 06/01/2012
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Provider Practice Location Address
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Address Line | 9207 COUNTRY CREEK DR SUITE 111
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City | HOUSTON
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State | TX
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Zip | 77036-7745
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Country | US
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Telephone | 832-202-3244
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Fax |
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Provider Business Mailing Address
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Address Line | 9207 COUNTRY CREEK DR SUITE 111
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City | HOUSTON
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State | TX
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Zip | 77036-7745
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Country | US
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Telephone | 832-202-3244
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | SAMUEL U UBOKUDOM
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Credential |
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Telephone | 832-202-3244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | L7754
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License Number State | TX
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