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1336645928
THEODORE BULACAN MENDOZA
ARLINGTON, TX
NPI
1336645928
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: TX AP136094)
Enumeration Date
2018-04-03
Last Update Date
2018-04-03
Business Address
THEODORE BULACAN MENDOZA FNP-BC
6407 S COOPER ST STE 117
ARLINGTON, TX 76001-5813
Phone number: 817-472-7601
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Mailing Address
THEODORE BULACAN MENDOZA FNP-BC
7328 LAGUNA
GRAND PRAIRIE, TX 75054-0139
Phone number: 972-898-8933
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