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General NPI Number Information
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NPI Number | 1326364043
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Entity Type | Organization
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Legal Business Name | SPRING BRANCH ORTHODONTIC CENTER
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Dates
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Enumeration Date | 04/20/2010
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Last Update Date | 04/20/2010
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Provider Practice Location Address
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Address Line | 1901 POST OAK BLVD APT 2207
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City | HOUSTON
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State | TX
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Zip | 77056-3922
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Country | US
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Telephone | 713-450-1800
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Fax |
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Provider Business Mailing Address
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Address Line | 1901 POST OAK BLVD. #2207
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City | HOUSTON
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State | TX
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Zip | 77056
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Country | US
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Telephone | 713-450-1800
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | PATRICIA TRAN
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Credential | D.D.S.
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Telephone | 713-459-1800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 23527
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License Number State | TX
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