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General NPI Number Information
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NPI Number | 1912149121
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Entity Type | Organization
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Legal Business Name | JOHN W. MEYER M D PA
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Dates
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Enumeration Date | 04/02/2009
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Last Update Date | 01/30/2014
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Provider Practice Location Address
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Address Line | 3200 AVENUE E
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City | HONDO
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State | TX
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Zip | 78861-3525
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Country | US
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Telephone | 512-280-7943
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Fax | 512-291-5657
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Provider Business Mailing Address
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Address Line | 1604 FM 1626
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City | MANCHACA
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State | TX
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Zip | 78652
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Country | US
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Telephone | 512-280-7943
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Fax | 512-291-5657
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Authorized Official
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Title or Position | CONTRACTING AGENT
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Name | CAROLE D DEVOS
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Credential |
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Telephone | 512-280-7943
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | E3732
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License Number State | TX
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