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General NPI Number Information
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NPI Number | 1568490621
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Entity Type | Individual
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Provider Name | ASHLEY MALCOM HUDDLESTON M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 1300 W ROSEDALE ST STE A
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City | FORT WORTH
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State | TX
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Zip | 76104-2824
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Country | US
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Telephone | 817-730-5300
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Fax | 817-989-6819
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Provider Business Mailing Address
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Address Line | 1 CHISHOLM TRAIL RD STE 5200
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City | ROUND ROCK
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State | TX
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Zip | 78681-5090
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Country | US
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Telephone | 512-202-3830
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Fax | 512-354-1106
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 01059420A
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License Number State | IN
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