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General NPI Number Information
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NPI Number | 1205189198
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Entity Type | Organization
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Legal Business Name | JNJM ENTERPRISE
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Dates
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Enumeration Date | 10/17/2012
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Last Update Date | 08/28/2013
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Provider Practice Location Address
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Address Line | 3455 STAGG DR SUITE 100
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City | BEAUMONT
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State | TX
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Zip | 77701-4521
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Country | US
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Telephone | 281-684-8535
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Fax | 281-647-0649
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Provider Business Mailing Address
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Address Line | PO BOX 1983
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City | LEAGUE CITY
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State | TX
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Zip | 77574-1983
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Country | US
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Telephone | 281-684-8535
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Fax | 281-647-0649
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Authorized Official
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Title or Position | CLINIC MANAGER
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Name | MS. MONAL JANAK PATEL
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Credential | MHA, MBA
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Telephone | 281-684-8535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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