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General NPI Number Information
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NPI Number | 1245316884
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Entity Type | Individual
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Provider Name | MARK CESTA MD
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Gender | Male
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 1705 JACKSON ST
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City | RICHMOND
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State | TX
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Zip | 77469
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Country | US
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Telephone | 616-734-0335
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Fax |
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Provider Business Mailing Address
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Address Line | 7474 N GRAND PKWY W STE C1100
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City | SPRING
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State | TX
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Zip | 77379-1570
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Country | US
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Telephone | 713-338-6565
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Fax | 616-949-8540
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | M0035
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License Number State | TX
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