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General NPI Number Information
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NPI Number | 1336749837
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Entity Type | Individual
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Provider Name | KEVIN L GOINS RPH
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Gender | Male
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Dates
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Enumeration Date | 10/26/2020
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Last Update Date | 10/26/2020
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Provider Practice Location Address
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Address Line | 8520 N BEACH ST
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City | FORT WORTH
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State | TX
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Zip | 76244-4918
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Country | US
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Telephone | 817-514-9524
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Fax | 817-514-9439
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Provider Business Mailing Address
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Address Line | 8202 ITHACA DR
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City | ARLINGTON
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State | TX
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Zip | 76002-4423
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Country | US
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Telephone | 214-476-1601
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Fax |
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 35742
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License Number State | TX
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