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General NPI Number Information
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NPI Number | 1225212251
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Entity Type | Organization
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Legal Business Name | PAUL ERIC STOUFFLET
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Dates
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Enumeration Date | 12/27/2007
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Last Update Date | 12/27/2007
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Provider Practice Location Address
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Address Line | 715 W 34TH ST
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City | AUSTIN
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State | TX
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Zip | 78705-1223
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Country | US
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Telephone | 512-380-9441
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Fax | 512-380-9410
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Provider Business Mailing Address
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Address Line | PO BOX 90969
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City | AUSTIN
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State | TX
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Zip | 78709-0969
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Country | US
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Telephone | 512-828-6959
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Fax | 512-698-5215
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Authorized Official
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Title or Position | OWNER
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Name | DR. PAUL ERIC STOUFFLET
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Credential | MD
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Telephone | 512-380-9441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | H8440
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License Number State | TX
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