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General NPI Number Information
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NPI Number | 1235858119
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Entity Type | Organization
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Legal Business Name | ONE SOURCE MEDICAL & REGENERATIVE SERVICES LLC
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Dates
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Enumeration Date | 08/24/2022
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Last Update Date | 12/27/2022
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Provider Practice Location Address
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Address Line | 8313 SOUTHWEST FWY STE 300
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City | HOUSTON
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State | TX
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Zip | 77074-1608
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Country | US
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Telephone | 713-784-2903
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Fax | 713-784-2908
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Provider Business Mailing Address
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Address Line | 412 E 18TH ST
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City | WESLACO
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State | TX
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Zip | 78596-8032
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Country | US
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Telephone | 915-929-9904
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/MD
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Name | JAMES ROBLES
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Credential | MD
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Telephone | 713-784-2903
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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