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General NPI Number Information
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NPI Number | 1477944833
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Entity Type | Organization
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Legal Business Name | CLINICA SAN DANIEL
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Dates
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Enumeration Date | 02/06/2015
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Last Update Date | 02/06/2015
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Provider Practice Location Address
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Address Line | 10904 SCARSDALE BLVD STE 275
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City | HOUSTON
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State | TX
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Zip | 77089-6035
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Country | US
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Telephone | 281-481-0770
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Fax | 281-481-0706
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Provider Business Mailing Address
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Address Line | 10904 SCARSDALE BLVD STE 275
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City | HOUSTON
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State | TX
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Zip | 77089-6035
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Country | US
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Telephone | 281-481-0770
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Fax | 281-481-0706
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | SANJUANA GAONA
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Credential |
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Telephone | 281-481-0770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | P1754
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License Number State | TX
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