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General NPI Number Information
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NPI Number | 1073958435
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Entity Type | Individual
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Provider Name | MR. RAJA VEGE
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Gender | Male
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Dates
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Enumeration Date | 04/30/2013
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Last Update Date | 04/30/2013
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Provider Practice Location Address
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Address Line | 820 S CONWAY AVE
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City | MISSION
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State | TX
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Zip | 78572
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Country | US
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Telephone | 956-581-2180
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Fax |
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Provider Business Mailing Address
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Address Line | 3616 S RHONDA ST
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City | EDINBURG
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State | TX
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Zip | 78539-3135
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Country | US
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Telephone | 956-739-3180
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 46893
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License Number State | TX
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