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General NPI Number Information
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NPI Number | 1972693471
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Entity Type | Individual
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Provider Name | JACQUELINE F FOURNIER MD
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Gender | Female
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 08/19/2019
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Provider Practice Location Address
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Address Line | 27760 RANCH ROAD 12 BLDG 1
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City | DRIPPING SPRINGS
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State | TX
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Zip | 78620
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Country | US
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Telephone | 512-829-9118
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Fax | 512-406-7301
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Provider Business Mailing Address
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Address Line | 6210 E US HWY 290 STE 420 - CREDENTIALING
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City | AUSTIN
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State | TX
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Zip | 78723-1098
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Country | US
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Telephone | 512-338-3826
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Fax | 512-406-6216
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | K2903
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License Number State | TX
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