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General NPI Number Information
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NPI Number | 1992979900
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Entity Type | Organization
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Legal Business Name | WM. KENT JOHNSON, M.D., F.A.C.S., P.A.
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Dates
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Enumeration Date | 04/22/2008
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Last Update Date | 04/22/2008
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Provider Practice Location Address
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Address Line | 17203 RED OAK DR STE 103
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City | HOUSTON
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State | TX
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Zip | 77090-2612
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Country | US
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Telephone | 281-893-2288
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Fax | 281-893-2882
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Provider Business Mailing Address
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Address Line | 17203 RED OAK DR STE 103
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City | HOUSTON
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State | TX
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Zip | 77090-2612
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Country | US
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Telephone | 281-893-2288
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Fax | 281-893-2882
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Authorized Official
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Title or Position | SECRETARY
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Name | ROSIE VAILES
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Credential |
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Telephone | 281-893-2288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | H6320
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License Number State | TX
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