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General NPI Number Information
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NPI Number | 1033416870
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Entity Type | Organization
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Legal Business Name | BRYAN L TOWNSEND MD PA
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Dates
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Enumeration Date | 02/14/2011
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Last Update Date | 04/20/2011
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Provider Practice Location Address
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Address Line | 8044 SHOAL CREEK BLVD
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City | AUSTIN
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State | TX
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Zip | 78757-8039
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Country | US
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Telephone | 512-459-1269
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Fax | 512-459-1404
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Provider Business Mailing Address
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Address Line | 8044 SHOAL CREEK BLVD
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City | AUSTIN
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State | TX
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Zip | 78757-8039
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Country | US
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Telephone | 512-459-1269
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Fax | 512-459-1404
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Authorized Official
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Title or Position | OWNER
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Name | BRYAN L TOWNSEND
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Credential | MD
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Telephone | 512-459-1269
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | J4566
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | J4566
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License Number State | TX
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