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Patient Service Center VBMC-THIC 1717 Treasure Hills Blvd Harlingen, TX 78550 Office: 956-389-3300 698-4910 Fax: 956-389-3309 Scheduling: 956-389-1852 Fax: Patient Name: VBMC-NOBI 5700 N Expwy # 109 Brownsville, TX 78526 Office and Scheduling: 956- 956-350-8716 DOB: Exam Appointment Date and Time: Diagnosis (Please write out diagnosis) Clinical History: Al.

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