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General NPI Number Information
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NPI Number | 1427412055
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Entity Type | Individual
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Provider Name | LUCAS EDGARDO CAVALLIN MD, PHD
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Gender | Male
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Dates
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Enumeration Date | 04/09/2016
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Last Update Date | 06/11/2022
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Provider Practice Location Address
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Address Line | 1400 N COIT RD STE 501
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City | MCKINNEY
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State | TX
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Zip | 75071-6657
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Country | US
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Telephone | 214-556-1222
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Fax | 214-556-2923
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Provider Business Mailing Address
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Address Line | 1400 N COIT RD STE 501
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City | MCKINNEY
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State | TX
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Zip | 75071-6657
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Country | US
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Telephone | 214-556-1222
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Fax | 214-556-2923
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | S6145
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License Number State | TX
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