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General NPI Number Information
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NPI Number | 1922272111
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Entity Type | Individual
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Provider Name | LAWRENCE JAMES SHEPLAN OLSEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/17/2008
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 12446 WEST AVE STE 200
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City | SAN ANTONIO
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State | TX
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Zip | 78216-2530
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Country | US
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Telephone | 787-718-1812
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Fax | 210-899-1529
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Provider Business Mailing Address
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Address Line | 8169 CALLE CONCORDIA STE 404
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City | PONCE
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State | PR
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Zip | 00717-1566
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Country | US
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Telephone | 787-718-1812
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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 | T1554
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 18420
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License Number State | PR
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