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General NPI Number Information
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NPI Number | 1740388131
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Entity Type | Organization
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Legal Business Name | CITYCARE CLINIC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 01/31/2024
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Provider Practice Location Address
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Address Line | 1720 COMMERCE STREET SUITE B
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City | GARLAND
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State | TX
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Zip | 75040
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Country | US
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Telephone | 972-205-3727
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Fax | 972-205-3444
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Provider Business Mailing Address
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Address Line | 1720 COMMERCE STREET SUITE B
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City | GARLAND
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State | TX
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Zip | 75040
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Country | US
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Telephone | 972-205-3727
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Fax | 972-205-3444
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Authorized Official
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Title or Position | CITY SUPERVISING PHYSCIAN
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Name | MR. CYRUS TIM LAMBERT
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Credential | M.D.
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Telephone | 972-205-3727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | L633
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License Number State | TX
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