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General NPI Number Information
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NPI Number | 1689030058
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Entity Type | Organization
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Legal Business Name | SATELLITE HEALTHCARE CENTRAL STATES, LLC
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Dates
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Enumeration Date | 01/14/2016
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Last Update Date | 05/15/2024
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Provider Practice Location Address
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Address Line | 910 GUADALUPE ST STE B
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City | LAREDO
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State | TX
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Zip | 78040-5280
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Country | US
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Telephone | 956-729-7411
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Fax | 956-729-0780
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Provider Business Mailing Address
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Address Line | 300 SANTANA ROW SUITE 300
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City | SAN JOSE
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State | CA
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Zip | 95128-2424
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Country | US
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Telephone | 956-729-7411
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Fax | 650-625-6007
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Authorized Official
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Title or Position | PRESIDENT/COO
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Name | MS. THOMAS WILLIAMS
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Credential |
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Telephone | 925-330-0823
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number | 110151
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License Number State | TX
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