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General NPI Number Information
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NPI Number | 1366433005
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Entity Type | Individual
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Provider Name | DANIEL GENE RENDEIRO PT, DSC, OCS
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Gender | Male
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Dates
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Enumeration Date | 11/02/2005
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 590 MEDICAL CENTER ROAD
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City | FORT CAVAZOS
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State | TX
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Zip | 76544
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Country | US
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Telephone | 254-288-6957
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Fax |
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Provider Business Mailing Address
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Address Line | 289 EAGLE LANDING DR
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City | BELTON
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State | TX
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Zip | 76513-5609
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Country | US
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Telephone | 210-912-5358
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 111777
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 1087146
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License Number State | TX
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