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General NPI Number Information
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NPI Number | 1841417789
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Entity Type | Organization
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Legal Business Name | CHAD E MOFFITT INC
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 09/05/2008
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Provider Practice Location Address
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Address Line | 2625 S LOOP 35 SUITE 161
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City | ALVIN
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State | TX
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Zip | 77511-4728
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Country | US
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Telephone | 281-585-8453
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Fax | 281-824-8711
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Provider Business Mailing Address
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Address Line | 2625 S LOOP 35 SUITE 161
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City | ALVIN
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State | TX
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Zip | 77511-4728
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Country | US
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Telephone | 281-585-8453
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Fax | 281-824-8711
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Authorized Official
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Title or Position | OWNER, DOCTOR
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Name | DR. CHAD E MOFFITT
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Credential | O.D.
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Telephone | 281-585-8453
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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 | 5433TG
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License Number State | TX
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