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General NPI Number Information
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NPI Number | 1700260684
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Entity Type | Organization
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Legal Business Name | ALVIN DIALYSIS RENAL
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Dates
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Enumeration Date | 07/10/2015
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Last Update Date | 07/10/2015
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Provider Practice Location Address
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Address Line | 101 EAST HOUSE STREET
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City | ALVIN
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State | TX
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Zip | 77511
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Country | US
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Telephone | 832-331-7148
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Fax | 281-315-9911
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Provider Business Mailing Address
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Address Line | 12240 MURPHY RD SUITE A
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City | STAFFORD
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State | TX
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Zip | 77477-2411
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Country | US
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Telephone | 832-331-7148
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Fax | 281-315-9911
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DR. JOYCE VOUKEP
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Credential | MD
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Telephone | 832-331-7148
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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 |
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License Number State | TX
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