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General NPI Number Information
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NPI Number | 1720566094
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Entity Type | Individual
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Provider Name | EULALIA DENEEN MYERS
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Gender | Female
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Dates
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Enumeration Date | 07/30/2018
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Last Update Date | 07/30/2018
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Provider Practice Location Address
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Address Line | 2443 FM 1488 RD APT 1102
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City | CONROE
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State | TX
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Zip | 77384-4937
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Country | US
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Telephone | 832-412-6113
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Fax |
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Provider Business Mailing Address
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Address Line | 602 W SEMANDS ST
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City | CONROE
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State | TX
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Zip | 77301-1867
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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 | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | 305306
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License Number State | TX
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