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General NPI Number Information
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NPI Number | 1043538689
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Entity Type | Individual
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Provider Name | SANTHISREE KOPALLI MD
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Gender | Female
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Dates
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Enumeration Date | 05/06/2010
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Last Update Date | 09/10/2024
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Provider Practice Location Address
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Address Line | 27045 E UNIVERSITY DR STE 1B
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City | AUBREY
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State | TX
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Zip | 76227-2746
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Country | US
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Telephone | 682-303-2330
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Fax | 682-303-2331
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Provider Business Mailing Address
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Address Line | PO BOX 733784
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City | DALLAS
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State | TX
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Zip | 75373-3784
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Country | US
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Telephone | 682-885-6483
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Fax | 682-885-3113
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | P7792
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License Number State | TX
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