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General NPI Number Information
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NPI Number | 1629683891
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Entity Type | Organization
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Legal Business Name | MED IV LLC
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Dates
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Enumeration Date | 09/14/2020
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Last Update Date | 09/14/2020
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Provider Practice Location Address
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Address Line | 23510 KINGSLAND BLVD STE 101
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City | KATY
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State | TX
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Zip | 77494-4126
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Country | US
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Telephone | 346-201-5743
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Fax | 346-396-2269
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Provider Business Mailing Address
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Address Line | PO BOX 131257
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City | SPRING
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State | TX
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Zip | 77393-1257
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Country | US
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Telephone | 346-201-5743
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Fax | 346-396-2269
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | STEVE ROPHAIL
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Credential |
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Telephone | 713-679-4487
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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