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General NPI Number Information
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NPI Number | 1144204595
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Entity Type | Individual
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Provider Name | JOEHASSIN CORDERO M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/30/2005
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Last Update Date | 03/25/2021
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Provider Practice Location Address
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Address Line | 3502 9TH ST SUITE 410
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City | LUBBOCK
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State | TX
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Zip | 79415-3300
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Country | US
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Telephone | 806-743-4115
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Fax | 806-743-1313
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Provider Business Mailing Address
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Address Line | PO BOX 5865
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City | LUBBOCK
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State | TX
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Zip | 79408-5865
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Country | US
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Telephone | 806-743-2898
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Fax | 806-743-2787
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | L6841
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License Number State | TX
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