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General NPI Number Information
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NPI Number | 1235222464
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Entity Type | Individual
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Provider Name | TRAVIS WALTRIP MD
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Gender | Male
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3141 HOOD ST STE 610
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City | DALLAS
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State | TX
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Zip | 75219-5021
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Country | US
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Telephone | 214-521-6495
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Fax | 214-521-6483
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Provider Business Mailing Address
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Address Line | 3141 HOOD ST STE 610
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City | DALLAS
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State | TX
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Zip | 75219-5021
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Country | US
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Telephone | 214-521-6495
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Fax | 214-521-6483
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | D8471
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License Number State | TX
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