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General NPI Number Information
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NPI Number | 1437505948
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Entity Type | Organization
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Legal Business Name | WATER LEAF SURGERY CENTER, LTD
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Dates
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Enumeration Date | 05/13/2016
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 5200 DAVIS LANE SUITE B100
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City | AUSTIN
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State | TX
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Zip | 78749
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Country | US
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Telephone | 737-802-3838
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Fax | 512-834-4142
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Provider Business Mailing Address
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Address Line | 7951 SHOAL CREEK BLVD STE 300
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City | AUSTIN
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State | TX
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Zip | 78757-7582
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Country | US
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Telephone | 512-584-8404
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Fax | 512-834-4142
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Authorized Official
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Title or Position | CEO
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Name | SANDFORD M SCHOCKET
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Credential | MD
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Telephone | 734-802-3839
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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