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General NPI Number Information
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NPI Number | 1811665839
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Entity Type | Organization
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Legal Business Name | JUAN BOTTO MD PA
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Dates
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Enumeration Date | 09/03/2021
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Last Update Date | 08/19/2022
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Provider Practice Location Address
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Address Line | 4912 WILLOW ST
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City | BELLAIRE
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State | TX
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Zip | 77401-4418
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Country | US
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Telephone | 713-428-2211
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Fax |
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Provider Business Mailing Address
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Address Line | 9450 SW GEMINI DR # 51007
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City | BEAVERTON
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State | OR
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Zip | 97008-7105
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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 | MD
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Name | JUAN BOTTO
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Credential |
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Telephone | 713-412-2221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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