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General NPI Number Information
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NPI Number | 1336050400
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Entity Type | Organization
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Legal Business Name | WHISTLE STOP PEDIATRICS
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Dates
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Enumeration Date | 09/16/2026
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Last Update Date | 09/16/2026
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Provider Practice Location Address
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Address Line | 310 E GOODE ST STE F
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City | QUITMAN
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State | TX
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Zip | 75783-2504
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Country | US
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Telephone | 903-287-6582
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Fax | 430-287-2741
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Provider Business Mailing Address
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Address Line | 407 CONGER ST
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City | QUITMAN
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State | TX
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Zip | 75783-2322
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Country | US
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Telephone | 903-287-6582
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Fax | 430-287-2741
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | BEVERLY SMITH HARGROVE
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Credential | APRN, CPNP-PC
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Telephone | 903-312-8575
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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 |
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License Number State |
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