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General NPI Number Information
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NPI Number | 1194884601
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Entity Type | Individual
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Provider Name | MUKAILA A RAJI MB, CHB
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Gender | Male
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 12424 HIGHWAY 6
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City | SANTA FE
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State | TX
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Zip | 77510-7608
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Country | US
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Telephone | 409-772-2222
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Fax | 409-772-0885
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Provider Business Mailing Address
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Address Line | 301 UNIVERSITY BLVD
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City | GALVESTON
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State | TX
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Zip | 77555-1022
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Country | US
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Telephone | 409-747-0890
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Fax | 409-772-0885
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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 | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | K8442
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License Number State | TX
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