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General NPI Number Information
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NPI Number | 1073551453
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Entity Type | Organization
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Legal Business Name | DREAMWISE ANESTHESIA ASSOCIATES PLLC
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 07/29/2009
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Provider Practice Location Address
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Address Line | 1201 W FRANK AVE
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City | LUFKIN
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State | TX
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Zip | 75904-3357
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Country | US
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Telephone | 936-639-3036
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1447
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City | LUFKIN
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State | TX
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Zip | 75902-1447
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Country | US
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Telephone | 936-639-3036
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | RYAN JOHNSON
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Credential | CRNA
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Telephone | 936-639-3036
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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