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General NPI Number Information
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NPI Number | 1902006380
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Entity Type | Individual
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Provider Name | RONNY FORD M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/23/2007
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Last Update Date | 05/30/2023
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Provider Practice Location Address
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Address Line | 11803 SOUTH FWY SUITE 112
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City | BURLESON
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State | TX
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Zip | 76028-7012
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Country | US
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Telephone | 817-293-5547
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Fax | 817-293-8551
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Provider Business Mailing Address
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Address Line | PO BOX 6278
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City | FORT WORTH
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State | TX
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Zip | 76115-0278
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Country | US
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Telephone | 817-293-5547
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Fax | 817-293-8551
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | BP1-0017553
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | BP1-0017553
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License Number State | TX
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