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General NPI Number Information
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NPI Number | 1467335463
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Entity Type | Organization
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Legal Business Name | CH STAFFORD LLC
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Dates
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Enumeration Date | 07/28/2025
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 112 AVENUE F STE B
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City | STAFFORD
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State | TX
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Zip | 77477-5502
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Country | US
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Telephone | 281-499-1121
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Fax | 281-499-1171
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Provider Business Mailing Address
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Address Line | 112 AVENUE F STE B
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City | STAFFORD
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State | TX
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Zip | 77477-5502
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Country | US
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Telephone | 281-499-1121
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Fax |
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Authorized Official
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Title or Position | FNP
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Name | REYNOL RAMON POLANCO SORIANO
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Credential |
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Telephone | 832-875-7716
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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