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NPI 1922818061

NPI 1922818061 : GAVIN MORELAND MD, P.C. : WEST LAKE HILLS, TX

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General NPI Number Information
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    NPI Number           |    1922818061
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    Entity Type          |    Organization 
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    Legal Business Name  |    GAVIN MORELAND MD, P.C. 
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Dates
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    Enumeration Date     |    01/10/2025
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    Last Update Date     |    01/10/2025
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Provider Practice Location Address
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    Address Line         |    111 WESTLAKE DR 
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    City                 |    WEST LAKE HILLS
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    State                |    TX
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    Zip                  |    78746-5301
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    Country              |    US
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    Telephone            |    504-458-4481
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3300 BEE CAVES RD STE 650 
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    City                 |    WEST LAKE HILLS
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    State                |    TX
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    Zip                  |    78746-6663
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    Country              |    US
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    Telephone            |    800-660-9085
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    Fax                  |    
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |     GAVIN  MORELAND 
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    Credential           |    MD
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    Telephone            |    504-458-4481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QH0100X
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    Taxonomy Name        |    Health Service Clinic/Center
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    License Number       |    
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    License Number State |    
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