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General NPI Number Information
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NPI Number | 1730465980
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Entity Type | Individual
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Provider Name | JOEL FERNANDEZ MD
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Gender | Male
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Dates
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Enumeration Date | 11/01/2011
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Last Update Date | 06/30/2022
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Provider Practice Location Address
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Address Line | 13601 WOODFORREST BLVD.
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City | HOUSTON
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State | TX
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Zip | 77015-4504
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Country | US
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Telephone | 713-330-4325
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Fax |
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Provider Business Mailing Address
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Address Line | 13601 WOODFORREST BLVD.
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City | HOUSTON
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State | TX
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Zip | 77015
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Country | US
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Telephone | 713-330-4325
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 31255
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | R4387
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License Number State | TX
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