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General NPI Number Information
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NPI Number | 1336582378
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Entity Type | Organization
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Legal Business Name | HEALTH DSA
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Dates
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Enumeration Date | 04/09/2013
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Last Update Date | 04/09/2013
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Provider Practice Location Address
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Address Line | 8026 VANTAGE DR SUITE 224
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City | SAN ANTONIO
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State | TX
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Zip | 78230-4733
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Country | US
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Telephone | 210-710-5742
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 591717
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City | SAN ANTONIO
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State | TX
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Zip | 78259-0135
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Country | US
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Telephone | 210-710-5742
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | BENJAMIN VELEZ
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Credential | R.D.C.S
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Telephone | 210-710-5742
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number | 025745
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License Number State | TX
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