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General NPI Number Information
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NPI Number | 1568049757
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Entity Type | Individual
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Provider Name | NICHOLAS PAUL MENZIONE JR. MD
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Gender | Male
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Dates
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Enumeration Date | 03/25/2021
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Last Update Date | 09/10/2024
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Provider Practice Location Address
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Address Line | 500 W MEDICAL CENTER BLVD
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City | WEBSTER
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State | TX
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Zip | 77598-4220
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Country | US
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Telephone | 281-332-2511
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Fax |
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Provider Business Mailing Address
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Address Line | 18333 EGRET BAY BLVD STE 140
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City | HOUSTON
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State | TX
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Zip | 77058-3239
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Country | US
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Telephone | 281-332-3001
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Fax | 281-332-3005
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | V1551
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License Number State | TX
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