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General NPI Number Information
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NPI Number | 1861743668
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Entity Type | Organization
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Legal Business Name | TROUPE EYECARE LLC
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Dates
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Enumeration Date | 09/20/2012
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Last Update Date | 02/24/2016
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Provider Practice Location Address
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Address Line | 4561 HERITAGE TRACE PARKWAY 109
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City | FORT WORTH
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State | TX
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Zip | 76244
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Country | US
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Telephone | 817-562-2010
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Fax | 817-549-8546
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Provider Business Mailing Address
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Address Line | 1600 W ARBROOK BLVD
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City | ARLINGTON
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State | TX
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Zip | 76015-4107
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Country | US
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Telephone | 817-562-2010
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Fax | 817-549-8546
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Authorized Official
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Title or Position | OWNER
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Name | AMANDA TROUPE
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Credential | OD
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Telephone | 817-562-2010
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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 | 861
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License Number State | MS
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