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General NPI Number Information
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NPI Number | 1346745692
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Entity Type | Organization
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Legal Business Name | SHARYLAND FAMILY MEDICAL CLINIC PLLC
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Dates
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Enumeration Date | 03/28/2018
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Last Update Date | 03/28/2018
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Provider Practice Location Address
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Address Line | 2118 E GRIFFIN PKWY
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City | MISSION
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State | TX
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Zip | 78572-3225
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Country | US
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Telephone | 956-581-2763
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Fax | 956-581-9962
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Provider Business Mailing Address
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Address Line | 2304 NICOLE DR
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City | MISSION
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State | TX
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Zip | 78574-9716
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Country | US
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Telephone | 956-703-6421
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Fax | 956-581-9962
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Authorized Official
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Title or Position | OWNER
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Name | PAUL JAMES KINDE
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Credential | MD
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Telephone | 956-581-2763
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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