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General NPI Number Information
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NPI Number | 1265697015
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Entity Type | Individual
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Provider Name | SHITAL MANOHAR RANA MD
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Gender | Female
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Dates
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Enumeration Date | 07/22/2008
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Last Update Date | 06/30/2014
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Provider Practice Location Address
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Address Line | 4140 HERITAGE TRACE PKWY SUITE 312
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City | KELLER
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State | TX
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Zip | 76244-5311
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Country | US
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Telephone | 817-741-7353
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Fax | 817-741-7501
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Provider Business Mailing Address
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Address Line | 4140 HERITAGE TRACE PKWY. SUITE 312
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City | KELLER
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State | TX
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Zip | 76244-5311
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Country | US
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Telephone | 817-714-7353
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Fax | 817-741-7501
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | N6598
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License Number State | TX
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