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General NPI Number Information
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NPI Number | 1043691017
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Entity Type | Organization
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Legal Business Name | MIDTOWN FAMILY CLINIC, INC.
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Dates
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Enumeration Date | 06/15/2015
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Last Update Date | 06/15/2015
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Provider Practice Location Address
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Address Line | 2101 CRAWFORD ST SUITE 208
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City | HOUSTON
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State | TX
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Zip | 77002-8942
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Country | US
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Telephone | 713-759-1641
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Fax | 713-759-9004
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Provider Business Mailing Address
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Address Line | 2101 CRAWFORD ST SUITE 208
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City | HOUSTON
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State | TX
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Zip | 77002-8942
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Country | US
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Telephone | 713-759-1641
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Fax | 713-759-9004
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | MKRTICH MIKE YEPREMIAN
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Credential |
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Telephone | 713-391-4444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | L8304
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License Number State | TX
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