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General NPI Number Information
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NPI Number | 1447766092
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Entity Type | Individual
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Provider Name | DELSHAVEON MASTERS
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Gender | Male
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Dates
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Enumeration Date | 12/19/2017
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Last Update Date | 12/19/2017
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Provider Practice Location Address
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Address Line | 2802 W TC JESTER BLVD APT 1
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City | HOUSTON
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State | TX
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Zip | 77018
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Country | US
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Telephone | 713-256-1714
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Fax |
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Provider Business Mailing Address
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Address Line | 2802 W T C JESTER BLVD APT 1
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City | HOUSTON
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State | TX
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Zip | 77018-7035
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Country | US
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Telephone | 832-228-8242
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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 | 224P00000X
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Taxonomy Name | Prosthetist
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License Number |
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License Number State |
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