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General NPI Number Information
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NPI Number | 1508912221
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Entity Type | Organization
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Legal Business Name | LYMPHEDEMA & WOUNDCARE INSTITUTE
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 09/28/2020
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Provider Practice Location Address
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Address Line | 10023 MAIN ST STE C8
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City | HOUSTON
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State | TX
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Zip | 77025-5252
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Country | US
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Telephone | 713-526-7926
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Fax | 281-786-1966
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Provider Business Mailing Address
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Address Line | PO BOX 20306
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City | HOUSTON
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State | TX
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Zip | 77225-0306
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Country | US
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Telephone | 713-526-7926
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Fax | 281-786-1966
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Authorized Official
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Title or Position | CEO
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Name | RYAN C CHUSTON
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Credential |
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Telephone | 832-236-7926
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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