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General NPI Number Information
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NPI Number | 1467207415
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Entity Type | Individual
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Provider Name | SMILE PREET KAUR
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Gender | Female
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Dates
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Enumeration Date | 04/23/2024
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 902 PRESKITT RD STE 300
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City | DECATUR
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State | TX
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Zip | 76234-4124
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Country | US
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Telephone | 940-626-1864
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Fax | 940-626-1865
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Provider Business Mailing Address
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Address Line | 125 WARRIOR LANE
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City | CLINTON
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State | MS
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Zip | 39056
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Country | US
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Telephone | 601-502-3067
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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