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NPI Code Detail

MEDICARE: DR. ASHLEY KLEIN DIMEOLA D.O.

MEDICARE:  DR. ASHLEY KLEIN DIMEOLA  D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2207RG0300XGeriatric Medicine (Internal Medicine) PhysicianP6965TX

General Provider Information

NPI Number : 1497915888
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ASHLEY KLEIN DIMEOLA D.O.
Provider Business Mailing Address
First Line : 7620 DEER RUN
Second Line :
City : VOLENTE
State : TX
Zip : 78641-6108
Country : US
Telephone Number : 512-291-7493
Fax Number : 888-592-7303
Provider Business Practice Location Address
First Line : 7620 DEER RUN
Second Line :
City : VOLENTE
State : TX
Zip : 78641-6108
Country : US
Telephone Number : 512-291-7493
Fax Number : 888-592-7303
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2008
Last Update Date : 09/23/2013

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Directions to “ DR. ASHLEY KLEIN DIMEOLA D.O.” Practice Location

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