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General NPI Number Information
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NPI Number | 1487886867
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Entity Type | Organization
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Legal Business Name | M TERESA VIVES MD LLC
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Dates
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Enumeration Date | 08/18/2009
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Last Update Date | 08/18/2009
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Provider Practice Location Address
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Address Line | 185 GREENBRIAR BLVD
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City | COVINGTON
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State | LA
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Zip | 70433-7234
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Country | US
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Telephone | 985-898-2001
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Fax | 985-898-2010
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Provider Business Mailing Address
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Address Line | 1437 AMELIA ST
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City | NEW ORLEANS
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State | LA
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Zip | 70115-3623
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Country | US
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Telephone | 504-899-4005
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Fax | 504-899-4993
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Authorized Official
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Title or Position | BUSSINESS OFFICE MANAGER
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Name | MS. MINDY K TURNER
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Credential |
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Telephone | 985-898-2001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 10138R
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License Number State | LA
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