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General NPI Number Information
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NPI Number | 1700303062
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Entity Type | Individual
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Provider Name | GENOVEVA ESTELLA GUERRERO
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Gender | Female
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Dates
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Enumeration Date | 08/28/2017
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Last Update Date | 11/02/2020
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Provider Practice Location Address
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Address Line | 11400 MISTY VALLEY DR
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City | HOUSTON
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State | TX
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Zip | 77066-3402
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Country | US
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Telephone | 832-484-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 1383 RICH LN
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City | BUDA
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State | TX
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Zip | 78610-9561
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Country | US
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Telephone |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2000039973
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License Number State | TX
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