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General NPI Number Information
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NPI Number | 1518128172
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Entity Type | Organization
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Legal Business Name | T COE BRANCH MD ASSOCIATED
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Dates
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Enumeration Date | 06/17/2008
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Last Update Date | 11/04/2008
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Provider Practice Location Address
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Address Line | 2404 YONKERS ST SUITE 7
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City | PLAINVIEW
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State | TX
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Zip | 79072-1820
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Country | US
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Telephone | 806-293-5161
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Fax | 806-296-5321
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Provider Business Mailing Address
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Address Line | 2404 YONKERS ST SUITE 7
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City | PLAINVIEW
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State | TX
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Zip | 79072-1820
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Country | US
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Telephone | 806-293-5161
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Fax | 806-296-5321
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Authorized Official
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Title or Position | OWNER
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Name | T COE BRANCH
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Credential | MD
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Telephone | 806-293-5161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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