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General NPI Number Information
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NPI Number | 1477748119
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Entity Type | Organization
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Legal Business Name | WAVE HEALTHCARE
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Dates
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Enumeration Date | 09/06/2007
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 121 INTERPARK BLVD STE 300
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City | SAN ANTONIO
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State | TX
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Zip | 78216-1852
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Country | US
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Telephone | 210-593-9283
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Fax | 210-593-9284
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Provider Business Mailing Address
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Address Line | 121 INTERPARK BLVD STE 300
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City | SAN ANTONIO
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State | TX
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Zip | 78216-1852
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Country | US
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Telephone | 210-593-9283
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Fax | 210-593-9284
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Authorized Official
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Title or Position | OWNER
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Name | MR. RODNEY GRAY
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Credential |
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Telephone | 210-593-9283
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2279H0200X
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Taxonomy Name | Home Health Registered Respiratory Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2279P3900X
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Taxonomy Name | Neonatal/Pediatric Registered Respiratory Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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