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General NPI Number Information
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NPI Number | 1508675117
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Entity Type | Organization
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Legal Business Name | THE WEEKEND CLINIC PLLC
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Dates
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Enumeration Date | 01/07/2025
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 9705 TEHAMA RIDGE PKWY STE A238
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City | FORT WORTH
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State | TX
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Zip | 76177-7507
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Country | US
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Telephone | 972-703-9027
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Fax | 469-933-2073
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Provider Business Mailing Address
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Address Line | PO BOX 528
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City | ROANOKE
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State | TX
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Zip | 76262-0528
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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 | AUTHORIZED OFFICIAL
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Name | MARCELA JAOKO
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Credential |
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Telephone | 972-703-9027
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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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