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General NPI Number Information
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NPI Number | 1073077202
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Entity Type | Organization
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Legal Business Name | SERGIO P. MAGGI, MD, PA
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Dates
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Enumeration Date | 01/22/2019
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Last Update Date | 02/21/2020
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Provider Practice Location Address
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Address Line | 3410 FAR WEST BLVD STE 110
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City | AUSTIN
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State | TX
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Zip | 78731-3187
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Country | US
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Telephone | 512-345-3223
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Fax |
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Provider Business Mailing Address
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Address Line | 3410 FAR WEST BLVD STE 110
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City | AUSTIN
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State | TX
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Zip | 78731-3187
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SERGIO MAGGI
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Credential | MD
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Telephone | 512-809-1980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number |
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License Number State |
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