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General NPI Number Information
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NPI Number | 1093035990
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Entity Type | Organization
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Legal Business Name | ROCKCASTLE MEDICAL CLINICS
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Dates
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Enumeration Date | 06/03/2010
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Last Update Date | 06/03/2010
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Provider Practice Location Address
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Address Line | 9207 COUNTRY CREEK DR SUITE 207
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City | HOUSTON
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State | TX
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Zip | 77036-7714
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Country | US
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Telephone | 713-981-7733
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Fax | 713-981-7734
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Provider Business Mailing Address
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Address Line | 9207 COUNTRY CREEK DR SUITE 207
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City | HOUSTON
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State | TX
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Zip | 77036-7714
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Country | US
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Telephone | 713-981-7733
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Fax | 713-981-7734
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Authorized Official
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Title or Position | DIRECTOR
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Name | RASAK A ANIMASHAWUN
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Credential |
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Telephone | 713-981-7733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number |
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License Number State |
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