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General NPI Number Information
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NPI Number | 1598921256
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Entity Type | Organization
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Legal Business Name | MID-LEVEL CARE, LLC
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Dates
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Enumeration Date | 08/01/2008
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Last Update Date | 08/01/2008
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Provider Practice Location Address
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Address Line | 2550 CROSS TIMBERS RD SUITE 116, MAILBOX 204
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City | FLOWER MOUND
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State | TX
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Zip | 75028-2621
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Country | US
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Telephone | 469-441-6845
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Fax | 877-801-2318
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Provider Business Mailing Address
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Address Line | 2550 CROSS TIMBERS RD SUITE 116, MAILBOX 204
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City | FLOWER MOUND
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State | TX
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Zip | 75028-2621
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Country | US
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Telephone | 469-441-6845
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Fax | 877-801-2318
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Authorized Official
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Title or Position | CO-OWNER
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Name | MR. RAFAEL POMALES JR.
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Credential | MHS, PA-C
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Telephone | 469-441-6845
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA 02974
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License Number State | TX
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