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General NPI Number Information
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NPI Number | 1235624040
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Entity Type | Organization
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Legal Business Name | EASTEX INFUSION SERVICES LLC
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Dates
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Enumeration Date | 06/25/2018
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Last Update Date | 11/11/2022
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Provider Practice Location Address
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Address Line | 27415 GRAYSON GAP CT
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City | FULSHEAR
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State | TX
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Zip | 77441-2087
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Country | US
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Telephone | 281-229-1531
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Fax | 281-946-8710
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Provider Business Mailing Address
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Address Line | 27415 GRAYSON GAP CT
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City | FULSHEAR
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State | TX
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Zip | 77441-2087
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Country | US
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Telephone | 832-451-6713
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Fax | 281-396-4705
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Authorized Official
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Title or Position | OWNER
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Name | JEROME AMADO
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Credential | RN
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Telephone | 832-338-6850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number | 018872
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 018872
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License Number State | TX
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