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General NPI Number Information
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NPI Number | 1801984455
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Entity Type | Individual
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Provider Name | MARY CONSTANCE WILLIAMS NP
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Gender | Female
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 11/29/2010
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Provider Practice Location Address
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Address Line | 3115 W PIPELINE RD
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City | EULESS
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State | TX
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Zip | 76040-6235
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Country | US
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Telephone | 817-399-3500
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Fax | 817-399-3506
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Provider Business Mailing Address
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Address Line | 1307 WOODVINE DR
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City | EULESS
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State | TX
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Zip | 76040-6442
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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 |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 451240
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License Number State | TX
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