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General NPI Number Information
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NPI Number | 1760995369
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Entity Type | Individual
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Provider Name | BRIAN MATTHEWS
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Gender | Male
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Dates
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Enumeration Date | 11/06/2017
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Last Update Date | 11/06/2017
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Provider Practice Location Address
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Address Line | 1045 GEMINI ST STE 105
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City | HOUSTON
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State | TX
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Zip | 77058-2705
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Country | US
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Telephone | 832-224-9222
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Fax |
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Provider Business Mailing Address
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Address Line | 3102 69TH ST APT 93
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City | GALVESTON
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State | TX
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Zip | 77551-2063
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Country | US
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Telephone | 254-405-0070
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 1278701
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License Number State | TX
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