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General NPI Number Information
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NPI Number | 1679760177
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Entity Type | Organization
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Legal Business Name | EILEEN A. SMITH M.D., P.A.
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Dates
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Enumeration Date | 09/27/2007
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Last Update Date | 01/07/2009
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Provider Practice Location Address
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Address Line | 8601 VILLAGE DR 118
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City | SAN ANTONIO
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State | TX
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Zip | 78217-5512
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Country | US
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Telephone | 210-967-0515
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Fax | 210-655-9697
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Provider Business Mailing Address
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Address Line | PO BOX 34567
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City | SAN ANTONIO
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State | TX
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Zip | 78265-4567
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Country | US
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Telephone | 210-967-0515
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Fax | 210-655-9697
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. EVONNIE P ESTRADA
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Credential |
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Telephone | 210-967-0515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | TXJ1141
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License Number State | TX
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