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General NPI Number Information
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NPI Number | 1487179990
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Entity Type | Organization
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Legal Business Name | MAXIMAL DIALYSIS CARE
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Dates
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Enumeration Date | 08/04/2017
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Last Update Date | 08/04/2017
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Provider Practice Location Address
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Address Line | 12220 MURPHY RD STE A
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City | STAFFORD
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State | TX
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Zip | 77477-2410
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Country | US
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Telephone | 832-331-2225
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Fax |
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Provider Business Mailing Address
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Address Line | 1602 KATY SHADOW LN
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City | KATY
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State | TX
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Zip | 77494-3850
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JOYCE OGBEBOR
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Credential |
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Telephone | 832-331-2225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | TX
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