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General NPI Number Information
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NPI Number | 1720474778
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Entity Type | Organization
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Legal Business Name | ICARE MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 04/07/2015
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Last Update Date | 04/07/2015
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Provider Practice Location Address
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Address Line | 3607 OAK LAWN AVE
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City | DALLAS
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State | TX
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Zip | 75219-4311
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Country | US
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Telephone | 713-838-0800
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Fax | 713-838-0887
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Provider Business Mailing Address
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Address Line | 6800 WEST LOOP S STE 300
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City | BELLAIRE
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State | TX
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Zip | 77401-4528
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Country | US
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Telephone | 713-838-0800
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Fax | 713-838-0887
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Authorized Official
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Title or Position | DIRECTOR
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Name | KAREN KUO
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Credential |
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Telephone | 870-819-1764
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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