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Individual

CLIFFORD TAGUTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
409 N LOOP 336 W STE 2, CONROE, TX 77301-1238
(936) 224-9802
Mailing address
409 N LOOP 336 W STE 2, CONROE, TX 77301-1238
(936) 224-9802

Taxonomy

Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NA
NA
Enumeration date
07/24/2017
Last updated
07/21/2022
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