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General NPI Number Information
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NPI Number | 1164181442
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Entity Type | Organization
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Legal Business Name | SOUTH EAST TEXAS POST ACUTE CARE SPECIALISTS INC
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Dates
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Enumeration Date | 12/14/2021
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Last Update Date | 09/02/2022
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Provider Practice Location Address
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Address Line | 1300 BAY AREA BLVD
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City | HOUSTON
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State | TX
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Zip | 77058-2505
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Country | US
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Telephone | 346-230-7095
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Fax | 281-984-7585
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Provider Business Mailing Address
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Address Line | 16516 EL CAMINO REAL # 252
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City | HOUSTON
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State | TX
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Zip | 77062-5723
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Country | US
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Telephone | 346-230-7095
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Fax | 281-984-7585
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Authorized Official
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Title or Position | PRESIDENT
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Name | GARY SPANGLER JR
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Credential |
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Telephone | 832-385-4835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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