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General NPI Number Information
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NPI Number | 1265240931
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Entity Type | Organization
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Legal Business Name | CROSS SORIANO OPTOMETRY PARTNERSHIP
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Dates
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Enumeration Date | 12/26/2024
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Last Update Date | 12/26/2024
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Provider Practice Location Address
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Address Line | 109 CARROLL ST STE 111
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City | FORT WORTH
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State | TX
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Zip | 76107-2068
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Country | US
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Telephone | 817-646-3449
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Fax |
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Provider Business Mailing Address
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Address Line | 5420 HUFFINES BLVD APT 6308
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City | FORT WORTH
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State | TX
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Zip | 76179-5638
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Country | US
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Telephone | 224-623-2846
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Fax |
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Authorized Official
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Title or Position | CO-OWNER/OPTOMETRIST
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Name | DR. MATT ANTHONY MACAYAN SORIANO
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Credential | OD
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Telephone | 224-623-2846
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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