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General NPI Number Information
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NPI Number | 1528293487
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Entity Type | Organization
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Legal Business Name | ALICE MEDICAL AND DIAGNOSTIC CENTER, P.A.
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Dates
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Enumeration Date | 05/21/2009
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Last Update Date | 05/21/2009
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Provider Practice Location Address
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Address Line | 230 S GULF ST
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City | ALICE
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State | TX
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Zip | 78332-4310
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Country | US
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Telephone | 361-661-0388
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Fax | 361-661-0631
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Provider Business Mailing Address
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Address Line | PO BOX 1760
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City | ALICE
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State | TX
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Zip | 78333-1760
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Country | US
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Telephone | 361-661-0388
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Fax | 361-661-0631
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. JOSE PEREZ
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Credential | M.D.
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Telephone | 361-661-0388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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