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General NPI Number Information
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NPI Number | 1750839817
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Entity Type | Organization
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Legal Business Name | CYPRESS EYE GROUP, PLLC
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Dates
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Enumeration Date | 09/19/2016
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Last Update Date | 09/19/2016
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Provider Practice Location Address
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Address Line | 4205 DOWLEN RD STE A
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City | BEAUMONT
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State | TX
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Zip | 77706-6885
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Country | US
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Telephone | 409-898-1879
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Fax |
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Provider Business Mailing Address
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Address Line | 14711 HAMPTON GREEN LN
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City | HOUSTON
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State | TX
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Zip | 77044-5791
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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 | MANAGER
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Name | DR. JITESH PATEL
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Credential | OD
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Telephone | 281-300-1447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 6791TG
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License Number State | TX
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