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General NPI Number Information
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NPI Number | 1891769402
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Entity Type | Individual
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Provider Name | BENJAMIN DAVID SMITH M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/13/2006
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Last Update Date | 09/24/2010
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Provider Practice Location Address
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Address Line | 1515 HOLCOMBE BLVD UNIT 1202
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City | HOUSTON
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State | TX
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Zip | 77030-4000
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Country | US
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Telephone | 713-563-2380
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Fax |
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Provider Business Mailing Address
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Address Line | 140 BEVERLY LN
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City | BELLAIRE
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State | TX
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Zip | 77401-5107
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Country | US
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Telephone | 210-244-3226
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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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 041591
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License Number State | CT
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