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General NPI Number Information
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NPI Number | 1760666440
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Entity Type | Organization
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Legal Business Name | CINCO RANCH VISION, LLC
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Dates
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Enumeration Date | 12/18/2007
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Last Update Date | 12/18/2007
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Provider Practice Location Address
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Address Line | 2944 S MASON RD SUITE H
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City | KATY
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State | TX
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Zip | 77450-1763
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Country | US
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Telephone | 281-347-3700
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Fax | 281-347-3701
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Provider Business Mailing Address
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Address Line | 2944 S MASON RD SUITE H
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City | KATY
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State | TX
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Zip | 77450-1763
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Country | US
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Telephone | 281-347-3700
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Fax | 281-347-3701
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Authorized Official
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Title or Position | MANAGER
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Name | DR. CHRISTINE M AGUILAR
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Credential | O.D.
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Telephone | 281-347-3700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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