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General NPI Number Information
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NPI Number | 1699287094
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Entity Type | Organization
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Legal Business Name | DENNIS D OBANION MD
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Dates
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Enumeration Date | 10/26/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1801 GALLERIA OAKS DR
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City | TEXARKANA
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State | TX
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Zip | 75503-4616
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Country | US
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Telephone | 903-614-4200
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Fax | 903-614-4244
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Provider Business Mailing Address
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Address Line | 2604 SAINT MICHAEL DR STE 239
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City | TEXARKANA
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State | TX
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Zip | 75503-2378
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Country | US
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Telephone | 903-614-5355
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Fax | 903-614-5399
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | SHARLEEN KEAHEY
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Credential |
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Telephone | 903-614-5355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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