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General NPI Number Information
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NPI Number | 1629283569
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF TEXAS MEDICAL BRANCH
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 05/18/2009
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Provider Practice Location Address
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Address Line | 301 UNIVERSITY BLVD RT 1022
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City | GALVESTON
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State | TX
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Zip | 77555-5302
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Country | US
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Telephone | 409-772-2222
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 4797-710
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City | HOUSTON
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State | TX
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Zip | 77210
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Country | US
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Telephone | 409-772-0848
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | CYTHINA L SMITH
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Credential |
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Telephone | 409-772-7710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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