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General NPI Number Information
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NPI Number | 1629597018
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Entity Type | Organization
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Legal Business Name | ARTERIES & VEINS CLINIC PLLC
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Dates
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Enumeration Date | 09/17/2017
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Last Update Date | 09/17/2017
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Provider Practice Location Address
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Address Line | 3107 OAK CREEK DR STE 120
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City | AUSTIN
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State | TX
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Zip | 78727-3025
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Country | US
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Telephone | 614-302-3561
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Fax |
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Provider Business Mailing Address
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Address Line | 518 W SAN ANTONIO AVE APT 8
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City | EL PASO
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State | TX
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Zip | 79901-1146
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. SANDEEP RAO
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Credential | MD
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Telephone | 614-302-3561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | N6601
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | N6601
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License Number State | TX
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