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General NPI Number Information
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NPI Number | 1699717215
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Entity Type | Individual
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Provider Name | JUSTIN MATTHEW TRANT MD
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Gender | Male
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 01/12/2025
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Provider Practice Location Address
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Address Line | 11392 STARFISH LN
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City | GALVESTON
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State | TX
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Zip | 77554-1440
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Country | US
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Telephone | 979-204-6804
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Fax |
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Provider Business Mailing Address
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Address Line | 11392 STARFISH LN
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City | GALVESTON
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State | TX
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Zip | 77554-1440
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Country | US
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Telephone | 979-204-6804
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Fax |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | M3768
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License Number State | TX
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