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General NPI Number Information
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NPI Number | 1184734014
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Entity Type | Individual
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Provider Name | GUILLERMO - GONZALEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2002 HOLCOMBE BLVD
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City | HOUSTON
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State | TX
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Zip | 77030-4211
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Country | US
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Telephone | 713-791-1414
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Fax |
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Provider Business Mailing Address
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Address Line | 3923 CRYSTAL LAKE CIR S
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City | PEARLAND
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State | TX
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Zip | 77584-2574
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Country | US
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Telephone | 281-412-3511
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD051866
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License Number State | PA
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