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General NPI Number Information
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NPI Number | 1538454731
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Entity Type | Individual
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Provider Name | OLGA SERGEYEVNA BACHILO MD
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Gender | Female
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Dates
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Enumeration Date | 06/15/2011
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Last Update Date | 01/31/2018
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Provider Practice Location Address
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Address Line | 6300 WEST LOOP S # 620
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City | BELLAIRE
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State | TX
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Zip | 77401-2900
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Country | US
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Telephone | 713-766-4643
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Fax |
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Provider Business Mailing Address
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Address Line | 9833 MARLINK
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City | HOUSTON
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State | TX
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Zip | 77025-4338
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Country | US
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Telephone | 832-647-1756
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | Q9946
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License Number State | TX
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