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General NPI Number Information
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NPI Number | 1639151947
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Entity Type | Individual
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Provider Name | KETAKI B. DAVE M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/14/2005
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Last Update Date | 05/02/2008
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Provider Practice Location Address
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Address Line | 3720 S I-35 E
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City | DENTON
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State | TX
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Zip | 76210-6857
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Country | US
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Telephone | 970-382-1022
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Fax | 970-380-7947
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Provider Business Mailing Address
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Address Line | PO BOX 911230
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City | DALLAS
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State | TX
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Zip | 75391-1230
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Country | US
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Telephone | 972-997-8000
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Fax | 972-437-9605
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | J1645
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License Number State | TX
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