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General NPI Number Information
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NPI Number | 1275859456
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Entity Type | Individual
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Provider Name | VANESSA CAROLINA GONNELLA M.D
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Gender | Female
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Dates
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Enumeration Date | 04/13/2010
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Last Update Date | 05/10/2024
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Provider Practice Location Address
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Address Line | 27524 WESTRIDGE CREEK LN STE D
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City | KATY
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State | TX
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Zip | 77494-5290
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Country | US
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Telephone | 281-505-1530
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Fax | 832-437-7535
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Provider Business Mailing Address
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Address Line | 27524 WESTRIDGE CREEK LN STE D
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City | KATY
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State | TX
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Zip | 77494-5290
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Country | US
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Telephone | 281-505-1530
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Fax | 832-437-7535
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | Q2285
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License Number State | TX
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