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General NPI Number Information
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NPI Number | 1184579054
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Entity Type | Individual
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Provider Name | HAYLEY MAREE DE BIVAR BRANCO
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Gender | Female
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Dates
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Enumeration Date | 03/04/2026
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Last Update Date | 03/04/2026
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Provider Practice Location Address
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Address Line | 5950 BERKSHIRE LN STE 225
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City | DALLAS
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State | TX
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Zip | 75225-5857
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Country | US
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Telephone | 214-550-2090
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Fax |
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Provider Business Mailing Address
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Address Line | 6711 CASTLE WOOD DR
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City | MIDLAND
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State | TX
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Zip | 79707-2241
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Country | US
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Telephone |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State | TX
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