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General NPI Number Information
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NPI Number | 1093808180
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Entity Type | Individual
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Provider Name | JOYCE E MAUK MD
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Gender | Female
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 02/05/2010
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Provider Practice Location Address
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Address Line | 1300 W LANCASTER AVE
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City | FORT WORTH
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State | TX
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Zip | 76102-3410
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Country | US
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Telephone | 817-336-8611
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Fax | 682-336-2823
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Provider Business Mailing Address
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Address Line | 1300 W LANCASTER
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City | FORT WORTH
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State | TX
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Zip | 76102-3484
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Country | US
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Telephone | 817-336-2823
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Fax | 682-885-7347
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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 | 2080P0008X
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Taxonomy Name | Pediatric Neurodevelopmental Disabilities Physician
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License Number | K6134
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License Number State | TX
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