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General NPI Number Information
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NPI Number | 1376957530
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Entity Type | Individual
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Provider Name | ASHLEY VARAKALAYIL O.D.
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Gender | Female
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Dates
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Enumeration Date | 06/16/2014
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 6850 N SHILOH RD
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City | GARLAND
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State | TX
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Zip | 75044-2912
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Country | US
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Telephone | 972-414-0444
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Fax |
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Provider Business Mailing Address
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Address Line | 259 BENWICK DR
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City | SUNNYVALE
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State | TX
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Zip | 75182-3256
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Country | US
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Telephone | 630-408-1805
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 046.010808
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 8538T
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License Number State | TX
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