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General NPI Number Information
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NPI Number | 1407470222
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Entity Type | Organization
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Legal Business Name | PRIME INTEGRATED HEALTH CLINICS LLC
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Dates
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Enumeration Date | 06/08/2020
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 1930 E ROSEMEADE PKWY STE 106
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City | CARROLLTON
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State | TX
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Zip | 75007-2467
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Country | US
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Telephone | 214-666-6651
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Fax |
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Provider Business Mailing Address
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Address Line | 1930 E ROSEMEADE PKWY STE 106
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City | CARROLLTON
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State | TX
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Zip | 75007-2467
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Country | US
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Telephone | 214-666-6651
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | FARZAD MARZBAN
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Credential | DC
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Telephone | 972-765-5676
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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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