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General NPI Number Information
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NPI Number | 1114983178
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Entity Type | Individual
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Provider Name | DAMYANTI S PATEL M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1201A BRIARCREST DR
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City | BRYAN
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State | TX
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Zip | 77802-5223
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Country | US
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Telephone | 979-776-9400
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Fax | 979-774-8903
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Provider Business Mailing Address
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Address Line | 1402 ESSEX GRN
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City | COLLEGE STATION
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State | TX
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Zip | 77845-8349
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Country | US
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Telephone | 979-696-1231
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | F6067
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License Number State | TX
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