NPI
LastName
FirstName
MidName
Organization
Mailing Address
City
State
Zip
1912017039
CLARK
TIMOTHY
MICHAEL
 
PO BOX 841656
DALLAS
TX
752841656
1831181213
GOOCH
ROSALYN
L.T.
 
800 E DAWSON ST
TYLER
TX
757012036
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