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NPI 1063251148

NPI 1063251148 : SARAH JEAN WILLIAMS RD : ROUND ROCK, TX

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General NPI Number Information
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    NPI Number           |    1063251148
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    Entity Type          |    Individual 
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    Provider Name        |    SARAH JEAN WILLIAMS RD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/20/2024
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    Last Update Date     |    05/20/2024
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Provider Practice Location Address
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    Address Line         |    300A UNIVERSITY BLVD 
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    City                 |    ROUND ROCK
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    State                |    TX
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    Zip                  |    78665-1032
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    Country              |    US
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    Telephone            |    512-509-2128
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3000 COLONIAL PKWY APT 4203 
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    City                 |    CEDAR PARK
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    State                |    TX
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    Zip                  |    78613-6610
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    Country              |    US
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    Telephone            |    512-509-2128
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    Fax                  |    
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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        |    133VN1301X
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    Taxonomy Name        |    Oncology Nutrition Registered Dietitian
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    License Number       |    DT85027
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    License Number State |    TX
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