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General NPI Number Information
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NPI Number | 1922467315
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Entity Type | Organization
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Legal Business Name | KYLE ER LLC
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Dates
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Enumeration Date | 02/15/2016
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Last Update Date | 07/08/2024
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Provider Practice Location Address
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Address Line | 5615 KYLE CENTER DR.
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City | KYLE
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State | TX
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Zip | 78640
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Country | US
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Telephone | 713-660-0555
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Fax | 832-787-1278
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Provider Business Mailing Address
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Address Line | 5615 KYLE CENTER DR
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City | KYLE
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State | TX
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Zip | 78640
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Country | US
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Telephone | 512-504-9950
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Fax | 512-504-9952
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | MRS. AMANDA JEAN DUPONT
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Credential | MD
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Telephone | 512-504-9950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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