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General NPI Number Information
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NPI Number | 1447835483
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Entity Type | Individual
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Provider Name | GRACE OLIVER
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Gender | Female
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Dates
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Enumeration Date | 03/11/2021
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Last Update Date | 03/11/2021
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Provider Practice Location Address
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Address Line | 5831 LE CARPE PLANTATION CT
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City | KATY
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State | TX
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Zip | 77449-5373
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Country | US
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Telephone | 832-687-0486
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Fax | 713-929-3572
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Provider Business Mailing Address
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Address Line | 6130 IRON ROCK ST
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City | HOUSTON
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State | TX
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Zip | 77087-3228
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Country | US
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Telephone | 832-687-0486
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Fax | 713-929-3572
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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 | 172A00000X
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Taxonomy Name | Driver
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License Number |
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License Number State |
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