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Organization
FAS OF TW LLC
Active
Organization
FAS OF TW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCIN NOBLE VACLAW DPM (PHYSICIAN)
(281) 909-7722
Entity
Organization
Contact information
Practice address
9191 PINECROFT DR STE 100, SHENANDOAH, TX 77380-2797
(346) 590-2730
Mailing address
434 W ASCENSION WAY STE 425, MURRAY, UT 84123-3102
(801) 292-4425
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
261QP1100X
Podiatric Clinic/Center
—
NULL
Other
Enumeration date
01/17/2025
Last updated
10/14/2025
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