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General NPI Number Information
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NPI Number | 1659646180
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Entity Type | Organization
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Legal Business Name | BYRKERWOOD SKIN AND VEIN CENTER, P.A.
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Dates
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Enumeration Date | 03/16/2012
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 1600 W 38TH ST SUITE 315
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City | AUSTIN
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State | TX
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Zip | 78731-6400
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Country | US
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Telephone | 512-302-1529
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 W 38TH ST SUITE 315
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City | AUSTIN
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State | TX
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Zip | 78731-6400
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Country | US
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Telephone | 512-302-1529
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. JACULEEN DANO
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Credential | MD
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Telephone | 512-302-4047
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State | TX
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