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General NPI Number Information
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NPI Number | 1942581913
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Entity Type | Individual
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Provider Name | MEHER SINDHOORA MAVURAM M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/06/2011
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 621 CAMDEN ST STE 202
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City | SAN ANTONIO
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State | TX
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Zip | 78215-1644
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Country | US
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Telephone | 210-253-3422
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Fax | 210-764-4231
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Provider Business Mailing Address
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Address Line | PO BOX 38150
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City | SHREVEPORT
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State | LA
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Zip | 71133-8150
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Country | US
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Telephone | 318-631-9121
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Fax | 318-631-9126
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MD.207117
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | U4428
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License Number State | TX
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