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General NPI Number Information
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NPI Number | 1962021220
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Entity Type | Individual
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Provider Name | RAJANI LATA SHRESTHA DO
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Gender | Female
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Dates
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Enumeration Date | 04/15/2020
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Last Update Date | 09/29/2023
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Provider Practice Location Address
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Address Line | 3107 W CAMP WISDOM RD STE 170
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City | DALLAS
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State | TX
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Zip | 75237-2638
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Country | US
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Telephone | 972-942-7700
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Fax | 972-941-7701
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Provider Business Mailing Address
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Address Line | 3107 W CAMP WISDOM RD STE 170
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City | DALLAS
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State | TX
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Zip | 75237-2638
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Country | US
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Telephone | 972-942-7700
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Fax | 972-941-7701
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | U0658
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License Number State | TX
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