ProviderBusinessMailingAddressFaxNumber = '9032237089'
NPI
LastName
FirstName
MidName
Organization
Mailing Address
City
State
Zip
1023005725
COLQUITT
LETHA
H
2101 GALLERIA OAKS DR
TEXARKANA
TX
755034625
1417949801
SMITH
PATRICK
N
5212 W 7TH ST
WAKE VILLAGE
TX
755015930
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