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General NPI Number Information
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NPI Number | 1861519274
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Entity Type | Individual
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Provider Name | MARK RYAN BOYLE MD
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Gender | Male
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 948 WILLIAM D FITCH PKWY
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City | COLLEGE STATION
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State | TX
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Zip | 77845-6452
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Country | US
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Telephone | 979-314-2323
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Fax |
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Provider Business Mailing Address
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Address Line | 6884 RIVERSTONE DR
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City | BRYAN
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State | TX
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Zip | 77808-2307
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | M4718
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License Number State | TX
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