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General NPI Number Information
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NPI Number | 1114331634
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Entity Type | Individual
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Provider Name | DIANNE SHERILL DAVIS M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/12/2014
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Last Update Date | 12/06/2024
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Provider Practice Location Address
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Address Line | 977 RAINTREE CIR STE 120
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City | ALLEN
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State | TX
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Zip | 75013-5024
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Country | US
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Telephone | 972-338-4528
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Fax | 972-662-8279
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Provider Business Mailing Address
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Address Line | 8825 BEE CAVES RD STE 100
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City | AUSTIN
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State | TX
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Zip | 78746-4721
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Country | US
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Telephone | 512-328-3376
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Fax | 512-666-3767
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | S2974
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License Number State | TX
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