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General NPI Number Information
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NPI Number | 1326604778
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Entity Type | Individual
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Provider Name | SHALONDA RENEE' JOHNSON CPT, CPI
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Gender | Female
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Dates
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Enumeration Date | 05/10/2019
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Last Update Date | 11/08/2020
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Provider Practice Location Address
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Address Line | 20751 CYPRESS CRESCENT LN
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City | CYPRESS
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State | TX
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Zip | 77433-6513
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Country | US
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Telephone | 832-983-1866
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Fax | 844-544-4514
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Provider Business Mailing Address
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Address Line | 5600 NW CENTRAL DR STE 280
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City | HOUSTON
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State | TX
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Zip | 77092-2065
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Country | US
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Telephone | 346-255-2192
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Fax | 832-201-7383
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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 | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State | TX
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